Placebo-controlled treatment trial of depression in elderly physically ill patients

Int J Geriatr Psychiatry. 1997 Aug;12(8):817-24. doi: 10.1002/(sici)1099-1166(199708)12:8<817::aid-gps645>;2-4.


Objectives: To determine the response of physically ill elderly depressed patients to treatment.

Design: Acute geriatric medical inpatients with depression, randomly assigned to an 8-week double-blind placebo-controlled trial of fluoxetine.

Main outcome measure: Response rate as defined by the 17-item Hamilton Depression Rating Scale.

Results: Eighty-two patients entered the trial; 62 patients (all those who had completed at least 3 weeks of treatment) were included in the efficacy analysis. Forty-two completed the full 8 weeks (21 in each group) with response rates of 67% in the fluoxetine group and 38% in the placebo group. No significant difference was found between the responses of the two groups (p = 0.12). There was a trend for results in the fluoxetine group to continue to improve with time. On secondary analysis those patients with serious physical illness who completed 5 or more weeks (N = 37) showed a significant improvement in mood if treated with fluoxetine (p = 0.02).

Conclusions: The main benefit of antidepressants is to approximately double the chances of recovery. This trial showed the response rate of the fluoxetine treated group was increased by a factor of 1.8 over the placebo group in an 8-week period. The presence of physical illness, often severe and/or multiple, did not reduce the effectiveness of the medication, which was well tolerated overall. Those with serious physical disease responded significantly better to drug treatment; this will require further work. Psychological support was also considered to be important.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antidepressive Agents, Second-Generation / therapeutic use*
  • Depressive Disorder / drug therapy*
  • Double-Blind Method
  • Female
  • Fluoxetine / therapeutic use*
  • Health Status
  • Humans
  • Male
  • Treatment Outcome


  • Antidepressive Agents, Second-Generation
  • Fluoxetine