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Office of Neuroscience Research > WUSTL Neuroscience News > Hard-to-treat depression in seniors focus of $13.5 million study

Hard-to-treat depression in seniors focus of $13.5 million study



From the WUSTL Newsroom...

Researchers at Washington University School of Medicine in St. Louis are launching a study aimed at identifying effective treatment methods for seniors with depression that does not respond to standard medications.

Nearly one-third of the 14 million Americans who live with clinical depression don’t get satisfactory relief from therapies prescribed to treat the disorder. And among older adults, more than half remain depressed even after treatment with antidepressant drugs.
 
With a $13.5 million grant from the Patient-Centered Outcomes Research Institute — an independent, nonprofit organization authorized by Congress under the Affordable Care Act — the researchers will study 1,500 adults over age 60 who have depression but have not responded to treatment.
 
“Older adults who are prescribed antidepressants often find that they don’t get better with the first or second medication they are prescribed,” said principal investigator Eric J. Lenze, MD, a professor of psychiatry. “So what should they get? This will be the largest and, we hope, the definitive study to answer that question. This study will show us which treatments work best and which are safest, and it will help us personalize treatment.”
 
The study will answer those questions by employing two treatment approaches: augmentation and switching of antidepressants. Every patient in the study will get treatment for 10 weeks, during which they either will receive an additional drug (augmentation) or a substitute medication in place of the antidepressant they already take (switch).
 
“Most patients will come to us already taking antidepressants called SSRIs (selective serotonin reuptake inhibitors), which include Prozac, Paxil, Zoloft or Lexapro,” Lenze said. “For patients in the augmentation branch of the study, we’ll add a second antidepressant to the one they’re already taking. Doctors often use this augmentation strategy in other medical illnesses such as high blood pressure or diabetes, in which a patient taking a single medication is not getting enough benefit. At that point, they add a second medication.”
 
In this study, the researchers will augment the patients’ SSRI drugs with aripiprazole (Abilify) or bupropion (Wellbutrin). A second group of patients will discontinue their current antidepressant drugs and switch to taking only bupropion.
 
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