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Patients with late-life depression may respond poorly to treatment

04-08 | Rachael

Patients with late-life depression may respond poorly to treatment

The onset of depression in later life poses other threats than the disease itself. According to a new research, late-life depression is difficult to treat, with elderly people responding differently to antidepressant therapy.

The study, titled “Antidepressant Response Trajectories and Associated Clinical Prognostic Factors among Older Adults,” said that patients who have late-life depression with high baseline depression are likely to respond poorly after 12 weeks of receiving treatment with Venlafaxine XR (antidepressant). However, the researchers feel that “high baseline depression severity alone may be neither a necessary nor sufficient predictor of treatment non-response.”

Continuing treatment is important

More than half of the older patients afflicted with major late-life depression usually do not respond properly to initial treatment with first-line pharmacotherapy. This trend goaded the researchers to initiate the study and look at the typical responses to the most prescribed antidepressant for older patients – Venlafaxine XR. The study, published in the JAMA Psychiatry in August 2015, also aimed at evaluating the clinical factors associated with response patterns.

However, this should not deter patients from continuing with the treatment. It may take time for patients to respond well to therapy, but there is still hope. Lead researcher of the study Dr Smagula told the Medscape Medical News, “You should get treated, and you should stay with it. Some of these patients take 12 weeks or more to fully respond. Late-life depression is often difficult to treat, and solo Venlafaxine is just not going to cut it for a lot of the patients out there. But get treated, stay with it, and also explore adjunctive care or alternatives, as indicated.”


It was found that late-life depression was very difficult to treat and that there was an array of different trajectories of response to Venlafaxine XR. Almost half of the participants in the study had distinct changes in symptoms in terms of severity and were deemed.

The study revealed that several factors contributed to a non-responsive trajectory, including baseline depression severity, sleep deprivation, more guilt, longer episode duration, and more work or activity impairment.

The severity of depression is a major deciding factor to the non-response to treatment. Robert P. Roca, M.D., M.P.H., vice president and medical director of the Sheppard Pratt Health System, told the Medscape Medical News, “The majority of patients with major depression do not fully recover in response to an initial course of antidepressant medication, and many do not even show a significant partial response.”

He also said, “Although we are still not very good at predicting who will respond, there are data showing a relationship between severity of depression and likelihood of response, in that people with higher initial levels of symptomatology may be less likely to show a significant response to antidepressant medications.”

The way ahead

The findings conform to earlier studies that patients who did not improve had high initial levels of depressive symptomatology. Dr. Roca lauded the initiative taken by researchers of the JAMA study for their efforts in identifying predictors of such a response for older patients. The problem of late-life depression in the elderly needs more extensive studies to elicit the actual reasons for this, he said.

If a loved one is suffering from depression, call the Depression Treatment Colorado at our 24/7 helpline number 866-427-5668 for immediate assistance. Our representatives are available round-the-clock to help patients suffering from depression in finding the right treatment.

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