IPA Press Releases

CLINICAL TRIALS NEEDED TO IDENTIFY BEST TREATMENT FOR DEPRESSION IN THE ELDERLY

Elderly people are being deprived of the best available treatment for depression, according to Dr Luis Agüera from Spain, who called for more clinical trials to evaluate therapies specifically for geriatric depression at the International Psychogeriatric Association Congress (Nice, France, 9-14 September). Around 15 % of older people in the community and between one-third and one half of those in nursing homes suffer from depression, yet there is a detrimental shortage of data on the efficacy of anti-depressants. 

Clinical trials are more usually conducted in younger people, but, said Dr Agüera, from the University Hospital Doce de Octubre in Madrid, for older people, other factors need to be taken into account. “Cognitive impairment, physical illnesses, cerebrovascular disease, and the interaction with other drugs being taken by a patient can affect the outcome of the treatment,” he said.

There is a tendency for physicians and psychiatrists to prescribe the drugs already proven to be well-tolerated by most patients. But newer ‘double action’ compounds that act on more than one neurotransmitter system and are better tolerated are being developed. Whilst the older drugs may help to alleviate depression, they often produce side-effects and the new compounds could work better. “Doctors should not settle for drugs that are merely adequate, because the patient could still be very ill. I urge my colleagues to try out new therapies that could produce a remission from depression,” said Dr Agüera. “Don’t just use old drugs in old people!” he added. 

Dr Agüera will present data from his studies comparing the use of traditional therapies, such as tryciclics, with novel and emerging drugs – SSRIs and the newer dual action NSRI and NaSSA. He found that tryciclics are still widely used, particularly when the current single action SSRIs fail. “The use of newer anti-depressants is low – lower than it should be,” he said. 

Dr Agüera emphasised that there are still some cases where the older drugs are preferable but more effort must be made in the choice of treatment for each patient. “There may be side effects seen with the newer drugs, but it is worth taking the risk for the benefits to be gained by the new classes of drugs,” he said. “The quality of later life is just as important as it is in earlier years,” he concluded. 

For further information contact
Elaine Snell
Tel +44 (0)20 7738 0424 (London UK), mobile +44 (0)7973 953794
Elaine.snell@which.net
IPA Press Office – 9-14 September only - tel: +33 (0)4 93 92 81 09 fax: +33 (0)4 93 92 81 11

Note to Editors
The International Psychogeriatric Association (IPA) is the premier multi-disciplinary organisation concerned with the mental health care of our ageing people around the world. 1500 psychiatrists, geriatricians, neurologists, nurses and other allied professionals are expected at the Tenth Congress of the IPA, Nice, France, 9-14 September 2001. Full details, including abstracts and programme –  www.ipa-online.org