Outcome of late-life depression after 3 years of sequential treatment

To study the outcome of a sequential treatment protocol in elderly, severely depressed in-patients.All 81 patients from a 12-week double-blind randomized controlled trial (RCT) comparing venlafaxine with nortriptyline were asked to participate in a 3 year follow-up study. Thirty-two patients who did not achieve remission during the RCT, entered an open sequential treatment protocol and were treated with augmentation with lithium, switch to a monoamine oxidase inhibitor or ECT.Seventy-eight of the 81 patients (96.3%) achieved a response [>= 50% reduction in Montgomery angstrom sberg Depression Rating Scale score) and 68 patients (84%) a complete remission (final MADRS scoreOur study demonstrates the importance of persisting with antidepressant treatment in elderly patients who do not respond to the first or second treatment.