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What characteristics in older patients with depression are associated with good medication response? To find out, researchers analyzed individual patient-level data (N=2283; age, >60) from seven placebo-controlled medication studies of major depression examined in a 2008 meta-analysis.
Patients with moderate-to-severe depression (Hamilton Rating Scale for Depression scores, >21) and illness duration greater than 10 years had robust responses to medication (58% vs. 31% for placebo), with a medium effect size (0.54). However, this group accounted for only 385 patients (17%). Among patients with both chronic and more-severe depression, differences were even more pronounced (effect size, 0.7; number needed to treat, 4). In contrast, among patien…