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Medientyp:
E-Artikel
Titel:
Lithium augmentation in geriatric depressed outpatients: A clinical report
Beteiligte:
Parker, Karen L.;
Mitmann, Nicole;
Shear, Neil H.;
Herrmann, Nathan;
Shulman, Kenneth I.;
Silver, Ivan L.;
Gardner, David M.;
Busto, Usoa E.
Erschienen:
Wiley, 1994
Erschienen in:
International Journal of Geriatric Psychiatry, 9 (1994) 12, Seite 995-1002
Beschreibung:
<jats:title>Abstract</jats:title><jats:p>Lithium augmentation of antidepressant therapy in elderly outpatients has not been systematically assessed. A prospective, practice‐based observational study of 44 patients comparing an antidepressant monotherapy group (<jats:italic>N</jats:italic> = 23) with a lithium augmentation group (<jats:italic>N</jats:italic> = 21) was conducted in a geriatric psychiatry, outpatient clinic. The severity of depression was evaluated with the Montgomery–Asberg Depression Rating Scale (MADRS), the DSM‐III‐R Global Assessment of Functioning (GAF), a treatment effectiveness rating (ER) and the Geriatric Depression Scale (GDS). Patient‐reported adverse events were systematically collected. The mean age for the group was 76.5 ± 6.0 years, 81.8% were female and the most common principal diagnosis was major depression (88.6%). Doxepin was the most commonly prescribed antidepressant (29.5%), followed by nortriptyline (27.2%) and phenelzine (15.9%). Patients receiving lithium augmentation were less depressed and functioning better than those in the antidepressant alone treatment group—MADRS: 8.5 ± 8.8 vs 13.9 ± 9.0 (<jats:italic>p</jats:italic> < 0.05); GAF: 77.9 ± 8.3 vs 68.5 ± 10.5 (<jats:italic>p</jats:italic> < 0.01); ER: X<jats:sup>2</jats:sup> = 4.5 (<jats:italic>p</jats:italic> < 0.05); GDS: 4.0 ± 2.7 vs 5.9 ± 4.3 (NS). Patients in the lithium group tended to report fewer adverse events (3.7 ± 2.1 vs 5.0 ± 3.0 (NS)). Results suggest that lithium augmented patients are less depressed and report fewer adverse events than those on antidepressants alone. Lithium appears to be a safe and effective addition to antidepressant pharmacotherapy in the elderly.</jats:p>