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Add-on quetiapine in the treatment of major depressive disorder in elderly patients with cerebrovascular damage.

Carta MG, Zairo F, Mellino G, Hardoy MC - Clin Pract Epidemiol Ment Health (2007)

Bottom Line: CGI-S scores decreased from baseline to Month 6: 5.8 +/- 0.7 (t0), 5.4 +/- 0.7 (t1), 5.0 +/- 0.8 (t3), and 4.5 +/- 1.0 (t6), with a significant improvement at 6 months compared with baseline (P = 0.006).A significant improvement over the 6-month period was also observed with HAM-D scores (t0 = 27.2 +/- 4.0, t6 = 14.8 +/- 3.8, P < 0.001).The promising results from this study warrant confirmation in large, randomized, double-blind, placebo-controlled studies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Public Health, University of Cagliari, Cagliari, Italy. mgcarta@tiscali.it.

ABSTRACT

Background: Depressive episodes in elderly patients with cerebrovascular damage are characterized by poor responses to standard antidepressants. Recent reports have suggested that the atypical antipsychotic, quetiapine may have antidepressant properties and, in mice, may prevents memory impairment and hippocampus neurodegeneration induced by global cerebral ischemia.

Objective: To evaluate the efficacy of combination therapy with quetiapine in depressed elderly patients with cerebrovascular damage.

Methods: An open-label, 6-month follow-up study of patients with major depressive disorder (DSM-IV) and cerebral abnormalities (assessed by MRI) without severe cognitive impairment. Patients who had not responded to standard antidepressants (months of treatment 6.5 +/- 7.2) additionally received quetiapine (300 +/- 111 mg/d). Patients were evaluated at baseline (t0) and Months 1, 3, and 6 (t1, t3, t6) using the Clinical Global Impressions Scale for Severity (CGI-S) and the Hamilton Depression Rating Scale (HAM-D).

Results: Nine patients were included in the study, with a mean age of 72.8 +/- 9.4 years. CGI-S scores decreased from baseline to Month 6: 5.8 +/- 0.7 (t0), 5.4 +/- 0.7 (t1), 5.0 +/- 0.8 (t3), and 4.5 +/- 1.0 (t6), with a significant improvement at 6 months compared with baseline (P = 0.006). A significant improvement over the 6-month period was also observed with HAM-D scores (t0 = 27.2 +/- 4.0, t6 = 14.8 +/- 3.8, P < 0.001).

Conclusion: In this study, quetiapine was efficacious as combination therapy in depressed elderly patients with cerebrovascular damage. The promising results from this study warrant confirmation in large, randomized, double-blind, placebo-controlled studies.

No MeSH data available.


Related in: MedlinePlus

Clinical characteristics of vascular depression.
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Figure 1: Clinical characteristics of vascular depression.

Mentions: A serious and common risk to the elderly is depression, which, if untreated, is associated with a high rate of relapse, an increased likelihood of chronicity, and an elevated rate of mortality [1]. Affective disorders (such as depression) and vascular disease (including heart disease) are frequently comorbid conditions that share certain etiopathogenetic and prognostic factors. If untreated, depressive episodes may worsen the course of vascular disease (particularly cerebrovascular diseases) and compromise both quality of life and lifespan expectation. The close correlation between these comorbidities recently led to the identification of so-called "vascular depression" (Figure 1) [2].


Add-on quetiapine in the treatment of major depressive disorder in elderly patients with cerebrovascular damage.

Carta MG, Zairo F, Mellino G, Hardoy MC - Clin Pract Epidemiol Ment Health (2007)

Clinical characteristics of vascular depression.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2228281&req=5

Figure 1: Clinical characteristics of vascular depression.
Mentions: A serious and common risk to the elderly is depression, which, if untreated, is associated with a high rate of relapse, an increased likelihood of chronicity, and an elevated rate of mortality [1]. Affective disorders (such as depression) and vascular disease (including heart disease) are frequently comorbid conditions that share certain etiopathogenetic and prognostic factors. If untreated, depressive episodes may worsen the course of vascular disease (particularly cerebrovascular diseases) and compromise both quality of life and lifespan expectation. The close correlation between these comorbidities recently led to the identification of so-called "vascular depression" (Figure 1) [2].

Bottom Line: CGI-S scores decreased from baseline to Month 6: 5.8 +/- 0.7 (t0), 5.4 +/- 0.7 (t1), 5.0 +/- 0.8 (t3), and 4.5 +/- 1.0 (t6), with a significant improvement at 6 months compared with baseline (P = 0.006).A significant improvement over the 6-month period was also observed with HAM-D scores (t0 = 27.2 +/- 4.0, t6 = 14.8 +/- 3.8, P < 0.001).The promising results from this study warrant confirmation in large, randomized, double-blind, placebo-controlled studies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Public Health, University of Cagliari, Cagliari, Italy. mgcarta@tiscali.it.

ABSTRACT

Background: Depressive episodes in elderly patients with cerebrovascular damage are characterized by poor responses to standard antidepressants. Recent reports have suggested that the atypical antipsychotic, quetiapine may have antidepressant properties and, in mice, may prevents memory impairment and hippocampus neurodegeneration induced by global cerebral ischemia.

Objective: To evaluate the efficacy of combination therapy with quetiapine in depressed elderly patients with cerebrovascular damage.

Methods: An open-label, 6-month follow-up study of patients with major depressive disorder (DSM-IV) and cerebral abnormalities (assessed by MRI) without severe cognitive impairment. Patients who had not responded to standard antidepressants (months of treatment 6.5 +/- 7.2) additionally received quetiapine (300 +/- 111 mg/d). Patients were evaluated at baseline (t0) and Months 1, 3, and 6 (t1, t3, t6) using the Clinical Global Impressions Scale for Severity (CGI-S) and the Hamilton Depression Rating Scale (HAM-D).

Results: Nine patients were included in the study, with a mean age of 72.8 +/- 9.4 years. CGI-S scores decreased from baseline to Month 6: 5.8 +/- 0.7 (t0), 5.4 +/- 0.7 (t1), 5.0 +/- 0.8 (t3), and 4.5 +/- 1.0 (t6), with a significant improvement at 6 months compared with baseline (P = 0.006). A significant improvement over the 6-month period was also observed with HAM-D scores (t0 = 27.2 +/- 4.0, t6 = 14.8 +/- 3.8, P < 0.001).

Conclusion: In this study, quetiapine was efficacious as combination therapy in depressed elderly patients with cerebrovascular damage. The promising results from this study warrant confirmation in large, randomized, double-blind, placebo-controlled studies.

No MeSH data available.


Related in: MedlinePlus