Mulsant Benoit H, Houck Patricia R, Gildengers Ariel G, Andreescu Carmen, Dew Mary Amanda, Pollock Bruce G, Miller Mark D, Stack Jacqueline A, Mazumdar Sati, Reynolds Charles F
Advanced Center in Intervention and Services Research for Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
J Clin Psychopharmacol. 2006 Apr;26(2):113-20. doi: 10.1097/01.jcp.0000204471.07214.94.
To determine the optimal duration of an antidepressant trial in elderly patients, the authors examined the probability of eventually responding to treatment based on early improvement.
Four hundred seventy-two elderly patients with major depression (nonpsychotic, nonbipolar) were treated under protocolized conditions for up to 12 weeks and assessed weekly with the Hamilton Rating Scale for Depression. The probability of full response after 12 weeks of treatment was calculated in patients who had not fully responded after periods of treatment that lasted for 4 to 10 weeks.
Most of the patients who had shown a partial improvement after 4 weeks of treatment became full responders after 4 or more additional weeks of treatment. By contrast, only a few of those who were nonresponders became full responders even after up to 8 additional weeks of treatment.
After 4 weeks of treatment, it is possible to reliably identify a subgroup of elderly patients with depression who are more likely to benefit from a change in their treatment than from a few additional weeks of treatment with the same agent.
为确定老年患者抗抑郁药试验的最佳疗程，作者基于早期改善情况研究了最终对治疗产生反应的概率。
472例患有重度抑郁症（非精神病性、非双相）的老年患者在标准化条件下接受长达12周的治疗，并每周用汉密尔顿抑郁评定量表进行评估。计算在持续4至10周的治疗期后未完全缓解的患者在治疗12周后完全缓解的概率。
在治疗4周后显示部分改善的大多数患者在额外治疗4周或更长时间后成为完全缓解者。相比之下，即使在额外治疗长达8周后，只有少数无反应者成为完全缓解者。
治疗4周后，可以可靠地识别出一组老年抑郁症患者，与继续使用同一药物额外治疗几周相比，他们更有可能从改变治疗中获益。
