Medication Treatment for Depression in Nursing Home Residents

University of Pennsylvania

Status: Completed

Conditions: Depression

Treatments: Drug: Antidepressant medication; Drug: No antidepressant medication

Study type: Observational

Funder types: Other; NIH

Identifiers

NCT00076622

R37MH051247 (U.S. NIH Grant/Contract)

DSIR AT-GP

Details and patient eligibility

About

This study will examine therapeutic and adverse effects of continuing versus discontinuing antidepressant medication in nursing home residents who have had no more than a single episode of depression and who no longer have depressive symptoms.

Full description

There are approximately 1.6 million nursing home residents in the United States. More than one third of these residents are taking antidepressant medications (ADs). Although ADs are effective, evidence suggests that they can lead to significant adverse events, including an increased risk of falls and bone fractures. Many depressed nursing home residents suffer from an initial episode of late-life depression and do not meet guideline-based recommendations for maintenance treatment. This study will examine the benefits and risks of long-term AD treatment in depressed nursing home residents whose single episode of depression has been in continuous remission for at least six months.

Participants will be randomly assigned to either continue or discontinue AD treatment. Participants will be monitored over a period of one year for recurrence of depression and related symptoms, as well as for the occurrence of falls, fractures, and other adverse events. Medical chart review, self-reported mood symptoms, and depression scales will be used to assess participants.

Enrollment: 94 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Current use of antidepressant medication
• Have been in remission from first episode of depression for 6 months or longer
• Currently residing in a long term care or assisted living facility

Exclusion criteria

• Bedridden
• Severe cognitive impairment

Trial design

94 participants in 4 patient groups

Randomized to drug continuation

Description:

Participants assigned to continue current antidepressant medication

Treatment:

Drug: Antidepressant medication

Randomized to drug discontinuation

Description:

Participants assigned to discontinue current antidepressant medication (no antidepressant medication)

Treatment:

Drug: No antidepressant medication

Participant preference to continue drug

Description:

Chose to continue antidepressant medication

Treatment:

Drug: Antidepressant medication

Participant preference to discontinue drug

Description:

Chose to discontinue antidepressant medication (no antidepressant medication)

Treatment:

Drug: No antidepressant medication