Nav: Home

UCLA leading a $13.9M effort to treat older adults with persistent depression

October 04, 2016

More than half of older adults who are treated for depression find that eventually their treatments are no longer effective. When depression persists, these people are at greater risk of accelerated aging, declining mental health and even suicide.

To help address this, UCLA and four other institutions have been awarded a $13.9 million grant to evaluate treatment strategies for older adults with depression who have not responded to medications. UCLA psychiatry professor Dr. Helen Lavretsky will serve as principal investigator on this new study.

"No more than 30 to 40 percent of people respond to first-line treatments," said Lavretsky, director of the Late-life Depression, Stress and Wellness Research Program at the Semel Institute for Neuroscience and Human Behavior at the David Geffen School of Medicine at UCLA. Usually first-line treatments are a type of antidepressant called a selective serotonin reuptake inhibitor. Such persistent depression decreases older adults' quality of life more than any other illness, Lavretsky said.

The study will provide clinicians with evidence on the comparative effectiveness of switching people to a new medication, or augmenting their current medication with a second drug. It will also explore how aging-related factors affect the benefits and risks of different antidepressant strategies. The researchers will recruit 300 people age 60 and older who have had at least two rounds of antidepressant treatment and are deemed to be "treatment-resistant."

People will be recruited using electronic medical records to identify those age 60 and older who are taking antidepressants or who took them in the recent past. In addition, referrals will be elicited from clinicians who are treating people for depression. Participants will receive either the drug aripiprazole (Abilify) or bupropion (Wellbutrin), in addition to their existing antidepressant medications, or, at the discretion of the clinician, will switch from their existing antidepressant medication to bupropion alone. Those people who do not respond to treatment during the first three-month phase will be given either lithium or nortriptyline during a second phase. All people will be monitored weekly.

Monitoring is important, said Lavretsky, since there are safety concerns about the use of antidepressants in older adults. These can include death, cardiovascular risks, cognitive decline and falls.

"Understanding the risks and benefits of antidepressant strategies in older adults could vastly improve the quality of life of seniors and save billions of dollars each year in health care costs," she said. "This public health issue is one that will rapidly grow with the aging of the U.S. and world populations."

The project aligns with UCLA's Depression Grand Challenge, a university-wide research initiative that aims to reduce the health and economic impacts of depression by half by the year 2050.

The UCLA arm of the study will involve UCLA primary care and psychiatry clinics, and affiliated programs with the Los Angeles County Department of Mental Health and the West Los Angeles Veterans Administration Medical Center.

The study is funded by the Patient-Centered Outcomes Research Institute, an independent, non-profit organization that funds evidence-based research to help people make better-informed health care decisions. In addition to the 300 participants from UCLA, a total of 1,500 people will be recruited and studied at four other sites -- Washington University in St. Louis, the University of Pittsburgh, the University of Toronto and Columbia University -- making the trial the largest-ever study of treatment-resistant depression in older adults.

University of California - Los Angeles Health Sciences

Related Depression Articles:

Which comes first: Smartphone dependency or depression?
New research suggests a person's reliance on his or her smartphone predicts greater loneliness and depressive symptoms, as opposed to the other way around.
Depression breakthrough
Major depressive disorder -- referred to colloquially as the 'black dog' -- has been identified as a genetic cause for 20 distinct diseases, providing vital information to help detect and manage high rates of physical illnesses in people diagnosed with depression.
CPAP provides relief from depression
Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.
Post-natal depression in dads linked to depression in their teenage daughters
Fathers as well as mothers can experience post-natal depression -- and it is linked to emotional problems for their teenage daughters, new research has found.
Being overweight likely to cause depression, even without health complications
A largescale genomic analysis has found the strongest evidence yet that being overweight causes depression, even in the absence of other health problems.
Don't let depression keep you from exercising
Exercise may be just as crucial to a depression patient's good health as finding an effective antidepressant.
Having an abortion does not lead to depression
Having an abortion does not increase a woman's risk for depression, according to a new University of Maryland School of Public Health-led study of nearly 400,000 women.
Mother's depression might do the same to her child's IQ
Roughly one in 10 women in the United States will experience depression, according to the Centers for Disease Control and Prevention.
Teenage depression linked to father's depression
Adolescents whose fathers have depressive symptoms are more likely to experience symptoms of depression themselves, finds a new Lancet Psychiatry study led by UCL researchers.
Anxiety and depression linked to migraines
In a study of 588 patients who attended an outpatient headache clinic, more frequent migraines were experienced by participants with symptoms of anxiety and depression.
More Depression News and Depression Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

In & Out Of Love
We think of love as a mysterious, unknowable force. Something that happens to us. But what if we could control it? This hour, TED speakers on whether we can decide to fall in — and out of — love. Guests include writer Mandy Len Catron, biological anthropologist Helen Fisher, musician Dessa, One Love CEO Katie Hood, and psychologist Guy Winch.
Now Playing: Science for the People

#541 Wayfinding
These days when we want to know where we are or how to get where we want to go, most of us will pull out a smart phone with a built-in GPS and map app. Some of us old timers might still use an old school paper map from time to time. But we didn't always used to lean so heavily on maps and technology, and in some remote places of the world some people still navigate and wayfind their way without the aid of these tools... and in some cases do better without them. This week, host Rachelle Saunders...
Now Playing: Radiolab

Dolly Parton's America: Neon Moss
Today on Radiolab, we're bringing you the fourth episode of Jad's special series, Dolly Parton's America. In this episode, Jad goes back up the mountain to visit Dolly's actual Tennessee mountain home, where she tells stories about her first trips out of the holler. Back on the mountaintop, standing under the rain by the Little Pigeon River, the trip triggers memories of Jad's first visit to his father's childhood home, and opens the gateway to dizzying stories of music and migration. Support Radiolab today at