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Continuing paroxetine treatment reduces recurrence of major depression in the elderly

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 Q Do paroxetine and psychotherapy reduce recurrent episodes of depression in the elderly?

METHODS

Embedded ImageDesign:

Two by two randomised controlled trial (randomisation stratified by number of episodes, use of additional pharmacotherapy, and degree of cognitive impairment).

Embedded ImageAllocation:

Unclear.

Embedded ImageBlinding:

Double blinded (for drug treatment).

Embedded ImageFollow up period:

Two years.

Embedded ImageSetting:

A university based clinic, Pittsburgh, USA; 1999 to 2005.

Embedded ImagePatients:

116 people (⩾70 years old) who achieved a recovery from major depression (DSM-IV and a score of ⩾15 on the Hamilton Rating Scale for Depression and ⩾17 on the Folstein Mini-Mental State Examination) with open label paroxetine (10 mg daily initially, titrated up to 40 mg daily if necessary) and psychotherapy. A recovery was defined as a Hamilton score of 0 to 10 for three consecutive weeks, maintained over another 16 weeks of paroxetine and psychotherapy. Participants could receive additional pharmacotherapy (lithium, bupropion, or nortriptyline).

Embedded ImageIntervention:

Maintenance treatment …

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