According to Mentalhelp.net:
Elderly patients with depression who do not respond to first-course drug therapy or who relapse from treatment may respond to additional medication, according to the results of a study published in the June issue of the American Journal of Psychiatry.
Mary Amanda Dew, Ph.D., of the University of Pittsburgh School of Medicine, and colleagues assessed the treatment of depression with paroxetine and interpersonal psychotherapy in 195 patients aged 70 and older.
Of these patients, 105 (53.8 percent) required augmentation with bupropion, nortriptyline or lithium, 77 of whom because they did not respond to treatment and 28 because they experienced a relapse. Sixty-nine patients received augmentation while the remainder did not due to comorbid conditions or withdrawal of consent.
Patients who responded well to first-round treatment had the best overall recovery rate (86.7 percent), while the rate for those who received augmentation due to lack of response and due to relapse was 50 percent and 66.7 percent, respectively.
"Despite a lower likelihood of recovery in elderly people receiving augmentation, the recovery by over one-half of such patients suggests the value of augmentation for those able to tolerate it," the authors conclude. "Need for augmentation presages slower recovery in patients showing initial inadequate response; those requiring it after early relapse recovered more quickly."
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