RESISTANT GERIATRIC DEPRESSIONS AND THERAPEUTIC RESPONSE TO MONOAMINE-OXIDASE INHIBITORS

  • 1 January 1983
    • journal article
    • research article
    • Vol. 18  (2) , 195-205
Abstract
Elderly depressed patients who met the Research Diagnostic Criteria (RDC) for major depressive illness, resistant to other types of treatment, were treated with phenelzine, a nonselective monoamine oxidase (MAO) inhibitor, for 2-7 wk, following 2 wk of placebo washout period. Dosage ranged from 15-75 mg daily. Clinical status of patients as well as vital signs, EKG and platelet MAO inhibition were measured weekly. All responders at the end of this period were followed for 1-2 yr. Analysis of the results showed a 65% response rate as measured by Hamilton Depression Scale, Beck and Self-Rating Scales. No significant drug effect in cognitive functioning, as measured by objective tests, was observed. Clinical improvement was sustained for all participants throughout the follow-up period with no side effects. A direct relationship between platelet MAO inhibition and clinical response was found. The majority of the responders (70%) had achieved high platelet MAO inhibition values (> 80%), while most of the nonresponders had platelet MAO inhibition values of < 80%. These findings have potential clinical and research implications for treating geriatric depression, especially the ones resistant to other forms of treatment.

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