New Drug Combo Improves Depression in Older Adults

Taking antipsychotic medication in addition to an antidepressant could help treat symptoms of depression in patients who do not respond to typical treatment, according to a recent study.

“Treatment-resistant major depression is common and potentially life-threatening in elderly people, in whom little is known about the benefits and risks of augmentation pharmacotherapy. We aimed to assess whether aripiprazole is associated with a higher probability of remission than is placebo,” explained the study’s authors.
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For the study, researchers evaluated 468 participants (age >60 years) diagnosed with depression over a 12-week duration.

Of the participants, 39% (181) did not achieve remission during a pre-trial with venlafaxine extended-release (150–300 mg/day) and were randomly assigned to take aripiprazole (91 participants) or a placebo (90 participants).

Overall, 44% of participants in the aripiprazole group achieved remission compared to 29% of those in the placebo group.

Akathisia was the most likely adverse effect of aripiprazole, reported in 24 of 91 participants compared to 1 out of 90 patients taking the placebo.

Aripiprazole was also associated with more cases of Parkinson’s disease (17% compared to 2%).

“In adults aged 60 years or older who do not achieve remission from depression with a first-line antidepressant, the addition of aripiprazole is effective in achieving and sustaining remission. Tolerability concerns include the potential for akathisia and Parkinsonism,” they concluded.

The complete study is published in the September issue of the Lancet.

-Michelle Canales

Reference:

Lenze EJ, Mulsant BH, Blumberger DM, et al. Efficacy, safety, and tolerability of augmentation pharmacotherapy with aripiprazole for treatment-resistant depression in late life: a randomized, double-blind, placebo-controlled trial. Lancet. 2015 September [epub ahead of print] doi: http://dx.doi.org/10.1016/S0140-6736(15)00308-6.