Posted on 03/15/2006 9:41:06 PM PST by neverdem
Antidepressants work better than psychotherapy in preventing relapses in elderly men and women who have recovered from depression, a new study suggests.
The government-financed study, published today in The New England Journal of Medicine, found that a combination of drugs and therapy was the best way to restore well-being in seriously depressed patients 70 and older. Once the patients had recovered, however, drug treatment was more effective over the next two years than once-a-month psychotherapy.
Experts said the results underscored the challenges of treating depression in people past retirement age who are buffeted by anxieties — about dying, losing friends, declining physical health — that are different from those of younger adult patients.
The report also suggests that an orchestrated combination of psychotherapy, medication and careful case management followed by continued drug treatment can keep more than 40 percent of elderly people well for at least two years.
Past studies have found that antidepressants alone are no better than placebos in relieving depression in people over 70, who tend to be more vulnerable to the drugs' side effects, including dizziness. But most of the estimated six million elderly Americans who suffer from depression receive little more than a prescription for an antidepressant if they receive treatment at all, psychiatrists say.
"What this study shows is how well we can do when people get the state-of-the-art treatment, from some of the best people in the field, but it's very rarely done this way," said Dr. Gary Kennedy, chief of geriatric psychiatry at the Montefiore Medical Center in the Bronx.
Dr. Charles Reynolds, a psychiatry professor at the University of Pittsburgh, led the study of 195 people 70 and older in a program that included daily doses of the antidepressant Paxil and 12 to 15 weekly, hourlong therapy sessions.
(Excerpt) Read more at nytimes.com ...
In my fevered imagination I can see a direct line from this report to my wallet.
Vitamin D!!!!
Drugs are more efficacious than chat. This is old news.
Slapping someone upside the head and telling them to stop wallowing in self-pity because no one is going to give a damn is even cheaper!
Told the Doctor to specify that the meds were prescribed for smoking cessation ONLY, or he'd hear from our lawyer if he left the impression in our file that it had ANYTHING to do with depression, whatsoever, due to fears health insurance underwriters have about the crippling effects of depression on one's health!!!
By October we'll both be on Medicare and then it doesn't matter because we'll never have to apply for health insurance and risk passing an application past and underwriter ever again if we play our cards right!!!
Amazing thing is... I've been selling health insurance since before there ever was a Medicare!!!
Oh! And I forgot to mention that the price we've been paying for a high deductible health insurance from the age of 60 to 65 is enough to give ANYONE a severe case of depression!!!
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FReepmail me if you want on or off my health and science ping list.
Its not our wallets that this report has in mind. The target is our homes and IRAs. Who in the sponsorship of this report deserves our trust?
I'm 73 and have every right to be depressed and don't think I can't read your mind...
The NYT has a vendetta against the harmless Ambien, but shifts gears to sing the praises of the 60's era mind control drugs linked to every psycho killer you can think of.
Google "Violence" "Zoloft" or any similar drug.
My doc gave that drug to me to quite smoking and it was like IV caffeine. The next one he gave me lead to auditory hallucinations. My tires played Jesu, Joy of Man's Desire and my unplugged DVR played Rush Limbaugh and other songs. I guess I don't do well with mood altering stuff.
What was fascinating is that during these hallucinations is that I had perfect recollection. Every note of the songs was perfect, Rush didn't speak in gibberish. It was exactly like listening to the radio.
This stuff had have come from my brain. It left me wondering is this what we do with the part of our brains we supposedly don't use and why? After this "adventure" I'd say we store a tremendous amount of auditory info.
I got so mean that I took up smoking rather than stay on the damn pills.
The problem is not that people who need antidepressants use them, it is that, especially for the elderly and the very young, there is a rush to medicate before understanding the problem.
People today have difficulty differentiating between sadness/grief and clinical depression, temporary feelings of being 'down' in mood but not suffering clinical depression. Too often people would rather medicate than face and make decisions about very real problems in their lives. Also, even in this affluent society vitamin, mineral, enzyme, hormone, etc, deficiencies abound, all of which can affect our moods for long-terms. I think this may be especially true of the elderly. Doctors too often prescribe what their patients demand instead of helping them discover the cause of their misery.
Nevertheless, the antidepressants truly are life-savers for the truly clinically depressed.
I just wonder about the 'research' cited in the article. The recommendations are just too broad. How many of those elderly are lonely, and once the pschotherapy is 'completed', and they're dumped by the therapists (insurance runs out for that, you know), then it's just easier to medicate them?
It becomes my business the minute someone asks me to pay for it, which has already happened. Now that it's my business, my position is that I want to pay for none of it. If you would rather my sympathy, make it so that someone else's depression doesn't mean stealing money from me by coercion and force.
I'm betting lots of studies will come out in favor of all sorts of prescription drugs for seniors, especially since the Pharmaceutical companies can stick the taxpayer with the bill.
I haven't said it isn't your business, and I don't really have a clue what you are on about(might be my fault). What exactly has 'already happend?
Yours kindly
Yep. Screw that. Now that it's my business, my default negotiating position must become (for my own financial survival) that they can shrivel up and die, for all I care. If I have a moral obligation to invest my money in anyone else's well-being, it's for my children, not for someone else's elderly parents whom they won't take care of voluntarily. I shouldn't suffer a financial penalty because someone else has wasted their life and is unhappy with it.
It's the prescription-drugs-for-seniors law... sold to the public as a $400 billion program in 2000 (which was already outrageous), currently $1.2 trillion (and counting) and we've yet to get an honest accounting of what it will really cost. That's what these studies are about, justifying yet more outlays from the taxpayer's wallet.
I've reached my limit in tolerating the never-ending march of specious reasons for the government to take the money I work hard to earn. I pay $35000/year in taxes alone - and I know from first-hand experience working with the government that a huge percentage of this money - perhaps 90% - is pure waste and corruption.
So I say, forget it. I've had it with paying for other peoples' problems. The only things which I will consent to pay for are those things necessary for the national defense. Everything else the government does with my dollar, it does under protest from me.
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