Atypical antipsychotics as add-on treatment in late-life depression

Sibel Cakir,1 Zeynep Senkal2 1Department of Psychiatry, Mood Disorders, Geriatric Psychiatry Unit, Istanbul Medical School, Istanbul University, 2Department of Psychiatry, Marmara University, Istanbul, Turkey Background: Second-generation antipsychotics (SGAs) have been used in the augmentation of t...

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Main Authors: Cakir S, Senkal Z
Format: Article
Language:English
Published: Dove Medical Press 2016-09-01
Series:Clinical Interventions in Aging
Subjects:
Online Access:https://www.dovepress.com/atypical-antipsychotics-as-add-on-treatment-in-late-life-depression-peer-reviewed-article-CIA
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spelling doaj-2d76ef53fe2a450db5e511eaf90cd35e2020-11-24T23:06:41ZengDove Medical PressClinical Interventions in Aging1178-19982016-09-01Volume 111193119828837Atypical antipsychotics as add-on treatment in late-life depressionCakir SSenkal ZSibel Cakir,1 Zeynep Senkal2 1Department of Psychiatry, Mood Disorders, Geriatric Psychiatry Unit, Istanbul Medical School, Istanbul University, 2Department of Psychiatry, Marmara University, Istanbul, Turkey Background: Second-generation antipsychotics (SGAs) have been used in the augmentation of treatment-resistant depression. However, little is known about their effectiveness, tolerability, and adverse events in the treatment of late-life depression, which were the aim of this study.Methods: The retrospective data of patients aged >65 years who had a major depressive episode with inadequate response to antidepressant treatment and had adjuvant SGA treatment were analyzed. The outcome measures were the number of the patients who continued to use SGAs in the fourth and twelfth weeks, adverse events, and changes in symptoms of depression. Results: Thirty-five patients were screened: 21 (60%) had quetiapine, twelve (34.28%) had aripiprazole, and two (5.71%) had olanzapine adjuvant treatment. The mean age was 72.17±5.02 years, and 65.7% of the patients were women. The mean daily dose was 85.71±47.80 mg for quetiapine, 3.33±1.23 mg for aripiprazole, and 3.75±1.76 mg for olanzapine. The Geriatric Depression Scale scores of all patients were significantly decreased in the fourth week and were significant in the aripiprazole group (P=0.02). Of the 35 patients, 23 (65.7%) patients discontinued the study within 12 weeks. The frequency of adverse events was similar in all SGAs, and the most common were sedation, dizziness, constipation, and orthostatic hypotension with quetiapine, and akathisia and headache because of aripiprazole. Conclusion: This study indicates that dropout ratio of patients with SGAs is high, and a subgroup of patients with late-life depression may benefit from SGAs. Effectiveness is significant in aripiprazole, and adverse events of SGAs were not serious but common in elderly patients. Keywords: treatment resistance, aripiprazole, quetiapine, olanzapine, elderlyhttps://www.dovepress.com/atypical-antipsychotics-as-add-on-treatment-in-late-life-depression-peer-reviewed-article-CIAsecond-generation antipsychoticslate-life depressionadd-on treatmentatypical antipsychoticselderlyadverse eventsaripiprazolequetiapinemajor depressive disorder
collection DOAJ
language English
format Article
sources DOAJ
author Cakir S
Senkal Z
spellingShingle Cakir S
Senkal Z
Atypical antipsychotics as add-on treatment in late-life depression
Clinical Interventions in Aging
second-generation antipsychotics
late-life depression
add-on treatment
atypical antipsychotics
elderly
adverse events
aripiprazole
quetiapine
major depressive disorder
author_facet Cakir S
Senkal Z
author_sort Cakir S
title Atypical antipsychotics as add-on treatment in late-life depression
title_short Atypical antipsychotics as add-on treatment in late-life depression
title_full Atypical antipsychotics as add-on treatment in late-life depression
title_fullStr Atypical antipsychotics as add-on treatment in late-life depression
title_full_unstemmed Atypical antipsychotics as add-on treatment in late-life depression
title_sort atypical antipsychotics as add-on treatment in late-life depression
publisher Dove Medical Press
series Clinical Interventions in Aging
issn 1178-1998
publishDate 2016-09-01
description Sibel Cakir,1 Zeynep Senkal2 1Department of Psychiatry, Mood Disorders, Geriatric Psychiatry Unit, Istanbul Medical School, Istanbul University, 2Department of Psychiatry, Marmara University, Istanbul, Turkey Background: Second-generation antipsychotics (SGAs) have been used in the augmentation of treatment-resistant depression. However, little is known about their effectiveness, tolerability, and adverse events in the treatment of late-life depression, which were the aim of this study.Methods: The retrospective data of patients aged >65 years who had a major depressive episode with inadequate response to antidepressant treatment and had adjuvant SGA treatment were analyzed. The outcome measures were the number of the patients who continued to use SGAs in the fourth and twelfth weeks, adverse events, and changes in symptoms of depression. Results: Thirty-five patients were screened: 21 (60%) had quetiapine, twelve (34.28%) had aripiprazole, and two (5.71%) had olanzapine adjuvant treatment. The mean age was 72.17±5.02 years, and 65.7% of the patients were women. The mean daily dose was 85.71±47.80 mg for quetiapine, 3.33±1.23 mg for aripiprazole, and 3.75±1.76 mg for olanzapine. The Geriatric Depression Scale scores of all patients were significantly decreased in the fourth week and were significant in the aripiprazole group (P=0.02). Of the 35 patients, 23 (65.7%) patients discontinued the study within 12 weeks. The frequency of adverse events was similar in all SGAs, and the most common were sedation, dizziness, constipation, and orthostatic hypotension with quetiapine, and akathisia and headache because of aripiprazole. Conclusion: This study indicates that dropout ratio of patients with SGAs is high, and a subgroup of patients with late-life depression may benefit from SGAs. Effectiveness is significant in aripiprazole, and adverse events of SGAs were not serious but common in elderly patients. Keywords: treatment resistance, aripiprazole, quetiapine, olanzapine, elderly
topic second-generation antipsychotics
late-life depression
add-on treatment
atypical antipsychotics
elderly
adverse events
aripiprazole
quetiapine
major depressive disorder
url https://www.dovepress.com/atypical-antipsychotics-as-add-on-treatment-in-late-life-depression-peer-reviewed-article-CIA
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