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How effective are antidepressant drugs for older patients with major depressive disorder? To find out, researchers conducted a meta-analysis, using patient-level data, of seven randomized, placebo-controlled trials that involved 2235 older patients (age, ≥60). Trial durations were 8 to 12 weeks; paroxetine, fluoxetine, citalopram, escitalopram, duloxetine, and bupropion were studied.
Drug treatment was significantly more effective than placebo, but the absolute difference in response rates was modest (49% vs. 40%). In the subgroup of 385 patients with long duration of illness (>10 years) and moderate-to-severe depression, the response rate was substantial (58% vs. 31% for drug vs. placebo). But among the remaining patients, response rates di…