Abstract
Objective
Previous studies of mixed aged and older adult samples with major depressive disorder (MDD) reported reduced depression response in anxious patients, but a systematic review and analysis has not been performed. Our aim was to determine if anxiety predicts antidepressant response in previously identified placebo‐controlled trials of second generation antidepressants for late‐life depression.
Method
From a previous systematic review that identified ten randomized, placebo‐controlled trials of community dwelling patients aged 60 or older with major depression, anxious patients were identified by a score ≥7 on the anxiety/somatization factor of the Hamilton Depression Rating Scale (HDRS). Response was defined as 50% or greater improvement on the HDRS or the Montgomery Asberg Depression Rating Scale. A meta‐analysis was performed using a random effects model to calculate Odds Ratios (OR).
Results
Data were available from eight trials having ten drug‐placebo contrasts that included 2322 anxious and 1387 non‐anxious patients. The odds ratio for response to drug compared to placebo in anxious patients was 1.57 (95% CI 1.15, 2.14; z = 2.86, n = 10, p < 0.001), in non‐anxious patients was 1.44 (95% CI 1.15, 1.80, z = 3.21, n = 10, p < 0.001), and did not differ between groups. Pooled response rates to drug and placebo respectively were 49.4% vs 37.4% in anxious patients and 44.2 vs 35.5% in non‐anxious patients.
Conclusions
In randomized, placebo‐controlled trials, anxiety in late‐life depression was not associated with decreased response to second generation antidepressants. Copyright © 2009 John Wiley & Sons, Ltd.