Canada – A new study discovered that older adults with clinical depression respond better to a second drug treatment based in antipsychotic medication along with prescription antidepressants. The research work was published in the UK journal ‘The Lancet’.

The investigation included researchers from the Centre for Addiction and Mental Health (CAMH) in Toronto and the Washington University School of Medicine in St. Louis. It was a multicenter clinical trial.

This is the first study that employs the existing strategy of using an antipsychotic drug to counter depression symptoms, to older adults, and works successfully. Credit: Adrees Latif/ Reuters

Moreover, older adults with a depression condition, do not tend to show an improvement when medicated with antidepressants. However, this new investigation proved through a clinical trial, which involved almost 500 participants over the age of 60, that combining both antidepressant and the antipsychotic medication, can help significantly older adults with clinical depression.

“This is a rare study because it looks at depression specifically in older adults. It’s important to treat older adults effectively, especially given that adults with late-life depression are at an increased risk of developing dementia. Our research demonstrates that older adults respond to treatment for depression.” says Dr. Benoit Mulsant, a co-author of the study and Senior Scientist at CAMH, as Eurekalert reported.

In addition, this is the first study that employs the existing strategy of using an antipsychotic drug to counter depression symptoms, to older adults, and works successfully.

Clinical Trial

In a first stage, all of the patients involved were treated with an extended-release formulation of antidepressants for a period of 12 weeks. However, after the 12 weeks period, half of the study population still presented depression symptoms and showed no improvement.

In a second stage, the patients who were previously treated with the antidepressant but were not improving, continued to receive the treatment but this time with an antipsychotic named aripiprazole while other patients received a placebo. In addition, the aripiprazole is usually prescribed to treat schizophrenia and manic episodes linked with bipolar disorder.

At the end of the study, the researchers evaluated the responses of patients, and found that both drugs combined led to a notable relief of depression in 44 percent of the ones who did not respond before comparing it to only 29 percent of those who were given the placebo.

“This study is a major advance in support of evidence-based care for older adults with depression. By publishing our findings in The Lancet, we hope particularly to reach primary care physicians, who provide most of the treatment for depressed older adults. The excellent safety and tolerability profile of aripiprazole, as well as its efficacy, should support its use in primary care, with appropriate medical monitoring.” says Dr. Charles F. Reynolds, a co-author of the study and the UPMC Endowed Professor in Geriatric Psychiatry at the University of Pittsburgh.

Side Effects

Several patients who were prescribed with both drugs, developed restlessness while others experienced stiffness, which is named ‘mild Parkinsonism.’ Despite this, the scientists said that the side effects are usually easy going and are not maintained for long and that the potential benefits of the new treatment surpass the side effects.

In addition, other side effects were expected to show, like weight increase, as well as metabolic problems, but they did not occur. The aripiprazole was a complete success, it did not have an effect on blood sugar, insulin or lipids, as antipsychotic medications usually have.

Furthermore, what scientists have to do now, is to determine which patients are likely to take advantage from the two-drug combo. According to the researchers “learning the answer is a goal for future research,” Eurekalert informed.

“One of the things we see as critical to our future research will be trying to better understand the factors that make some people respond to specific forms of treatment that may not work for others,” said lead author Dr. Eric J. Lenze, professor of psychiatry at Washington University in St. Louis, MO as reported by Medical News Today.

Source: Medical News Today