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Volume 354:2505-2506 June 8, 2006 Number 23
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Maintenance Treatment of Depression in Old Age

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by Reynolds, C. F.
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To the Editor: Reynolds et al. (March 16 issue)1 demonstrate that pharmacotherapy is effective at preventing the recurrence of major depression in elderly patients. However, the more specific conclusion that "maintenance treatment with paroxetine is effective" cannot be supported without additional data. Nearly one third of the patients in the study required augmented pharmacotherapy before randomization, and all pharmacotherapy was discontinued in the placebo group. The need for augmentation was associated with a higher risk of recurrence. Bupropion, one of the agents used for augmentation, has been shown to decrease the risk of relapse.2 Patients requiring augmentation probably had more . . . [Full Text of this Article]



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