Atypical antipsychotics as add-on treatment in late-life depression

Sibel Cakir,1 Zeynep Senkal2 1Department of Psychiatry, Mood Disorders, Geriatric Psychiatry Unit, Istanbul Medical School, Istanbul University, 2Department of Psychiatry, Marmara University, Istanbul, Turkey Background: Second-generation antipsychotics (SGAs) have been used in the augmentation of t...

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Autores principales:	Cakir S, Senkal Z
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	second-generation antipsychotics late-life depression add-on treatment atypical antipsychotics elderly adverse events aripiprazole quetiapine major depressive disorder Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/2d76ef53fe2a450db5e511eaf90cd35e
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spelling	oai:doaj.org-article:2d76ef53fe2a450db5e511eaf90cd35e2021-12-02T00:02:40ZAtypical antipsychotics as add-on treatment in late-life depression1178-1998https://doaj.org/article/2d76ef53fe2a450db5e511eaf90cd35e2016-09-01T00:00:00Zhttps://www.dovepress.com/atypical-antipsychotics-as-add-on-treatment-in-late-life-depression-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Sibel Cakir,1 Zeynep Senkal2 1Department of Psychiatry, Mood Disorders, Geriatric Psychiatry Unit, Istanbul Medical School, Istanbul University, 2Department of Psychiatry, Marmara University, Istanbul, Turkey Background: Second-generation antipsychotics (SGAs) have been used in the augmentation of treatment-resistant depression. However, little is known about their effectiveness, tolerability, and adverse events in the treatment of late-life depression, which were the aim of this study.Methods: The retrospective data of patients aged >65 years who had a major depressive episode with inadequate response to antidepressant treatment and had adjuvant SGA treatment were analyzed. The outcome measures were the number of the patients who continued to use SGAs in the fourth and twelfth weeks, adverse events, and changes in symptoms of depression. Results: Thirty-five patients were screened: 21 (60%) had quetiapine, twelve (34.28%) had aripiprazole, and two (5.71%) had olanzapine adjuvant treatment. The mean age was 72.17±5.02 years, and 65.7% of the patients were women. The mean daily dose was 85.71±47.80 mg for quetiapine, 3.33±1.23 mg for aripiprazole, and 3.75±1.76 mg for olanzapine. The Geriatric Depression Scale scores of all patients were significantly decreased in the fourth week and were significant in the aripiprazole group (P=0.02). Of the 35 patients, 23 (65.7%) patients discontinued the study within 12 weeks. The frequency of adverse events was similar in all SGAs, and the most common were sedation, dizziness, constipation, and orthostatic hypotension with quetiapine, and akathisia and headache because of aripiprazole. Conclusion: This study indicates that dropout ratio of patients with SGAs is high, and a subgroup of patients with late-life depression may benefit from SGAs. Effectiveness is significant in aripiprazole, and adverse events of SGAs were not serious but common in elderly patients. Keywords: treatment resistance, aripiprazole, quetiapine, olanzapine, elderlyCakir SSenkal ZDove Medical Pressarticlesecond-generation antipsychoticslate-life depressionadd-on treatmentatypical antipsychoticselderlyadverse eventsaripiprazolequetiapinemajor depressive disorderGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 11, Pp 1193-1198 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	second-generation antipsychotics late-life depression add-on treatment atypical antipsychotics elderly adverse events aripiprazole quetiapine major depressive disorder Geriatrics RC952-954.6
spellingShingle	second-generation antipsychotics late-life depression add-on treatment atypical antipsychotics elderly adverse events aripiprazole quetiapine major depressive disorder Geriatrics RC952-954.6 Cakir S Senkal Z Atypical antipsychotics as add-on treatment in late-life depression
description	Sibel Cakir,1 Zeynep Senkal2 1Department of Psychiatry, Mood Disorders, Geriatric Psychiatry Unit, Istanbul Medical School, Istanbul University, 2Department of Psychiatry, Marmara University, Istanbul, Turkey Background: Second-generation antipsychotics (SGAs) have been used in the augmentation of treatment-resistant depression. However, little is known about their effectiveness, tolerability, and adverse events in the treatment of late-life depression, which were the aim of this study.Methods: The retrospective data of patients aged >65 years who had a major depressive episode with inadequate response to antidepressant treatment and had adjuvant SGA treatment were analyzed. The outcome measures were the number of the patients who continued to use SGAs in the fourth and twelfth weeks, adverse events, and changes in symptoms of depression. Results: Thirty-five patients were screened: 21 (60%) had quetiapine, twelve (34.28%) had aripiprazole, and two (5.71%) had olanzapine adjuvant treatment. The mean age was 72.17±5.02 years, and 65.7% of the patients were women. The mean daily dose was 85.71±47.80 mg for quetiapine, 3.33±1.23 mg for aripiprazole, and 3.75±1.76 mg for olanzapine. The Geriatric Depression Scale scores of all patients were significantly decreased in the fourth week and were significant in the aripiprazole group (P=0.02). Of the 35 patients, 23 (65.7%) patients discontinued the study within 12 weeks. The frequency of adverse events was similar in all SGAs, and the most common were sedation, dizziness, constipation, and orthostatic hypotension with quetiapine, and akathisia and headache because of aripiprazole. Conclusion: This study indicates that dropout ratio of patients with SGAs is high, and a subgroup of patients with late-life depression may benefit from SGAs. Effectiveness is significant in aripiprazole, and adverse events of SGAs were not serious but common in elderly patients. Keywords: treatment resistance, aripiprazole, quetiapine, olanzapine, elderly
format	article
author	Cakir S Senkal Z
author_facet	Cakir S Senkal Z
author_sort	Cakir S
title	Atypical antipsychotics as add-on treatment in late-life depression
title_short	Atypical antipsychotics as add-on treatment in late-life depression
title_full	Atypical antipsychotics as add-on treatment in late-life depression
title_fullStr	Atypical antipsychotics as add-on treatment in late-life depression
title_full_unstemmed	Atypical antipsychotics as add-on treatment in late-life depression
title_sort	atypical antipsychotics as add-on treatment in late-life depression
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/2d76ef53fe2a450db5e511eaf90cd35e
work_keys_str_mv	AT cakirs atypicalantipsychoticsasaddontreatmentinlatelifedepression AT senkalz atypicalantipsychoticsasaddontreatmentinlatelifedepression
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Atypical antipsychotics as add-on treatment in late-life depression

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