Treatment response of lithium augmentation in geriatric compared to non-geriatric patients with treatment-resistant depression

J Affect Disord. 2019 May 15;251:136-140. doi: 10.1016/j.jad.2019.03.057. Epub 2019 Mar 20.

Abstract

Background: Lithium augmentation (LA) of antidepressants is an effective strategy for treatment-resistant depression (TRD). Nevertheless, it is rarely used in geriatric patients. The purpose of this study was to investigate treatment response of LA in geriatric compared to non-geriatric patients.

Method: In a prospective multicenter cohort study, severity of depression was measured weekly in 167 patients with unipolar depression (nage≥65years = 22; nage<65years = 145) at baseline and over at least four weeks of LA.

Results: Geriatric patients showed a significantly better response to LA compared to non-geriatric patients (Hazard Ratio = 1.91; p = 0.04).

Limitations: An important limitation of our study is the lack of a control group of LA and the missing evaluation of side effects in both groups.

Conclusions: This is the first study investigating the efficacy of LA for TRD in geriatric compared to non-geriatric patients. Our data suggest that LA is an effective treatment option in geriatric patients that clinicians might consider more frequently and earlier on in the course of treatment.

Keywords: Efficacy; Geriatric patients; Lithium augmentation; Treatment-resistant depression.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / therapeutic use*
  • Cohort Studies
  • Depression
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Treatment-Resistant / drug therapy*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Lithium Carbonate / therapeutic use*
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome

Substances

  • Antidepressive Agents
  • Lithium Carbonate