Efficacy of citalopram in the prevention of recurrent depression in elderly patients: placebo-controlled study of maintenance therapy

Background The highly recurrent nature of major depression in the young and the elderly warrants long-term antidepressant treatment. Aims To compare the prophylactic efficacy of citalopram and placebo in elderly patients; to evaluate long-term tolerability of citalopram. Method Out-patients, greater than or equal to65 years, with unipolar major depression (DSM-IV: 296.2 x or 296.3 x) and Montgomery-Asberg Depression Rating Scale score greater than or equal to22 were treated with citalopram 20-40 mg for 8 weeks. Responders continued on their final fixed dose of citalopram for 16 weeks before randomisation to double-blind treatment with citalopram or placebo for at least 48 weeks. Results Nineteen of the 60 patients using citalopram v. 41 of the 61 patients using placebo had recurrence. Time to recurrence was significantly different between citalopram- and placebo-patients, in favour of citalopram (log-rank test, P < 0.0001). Long-term treatment was well tolerated. Conclusions Long-term treatment with citalopram is effective in preventing recurrence of depression in the elderly and is well tolerated. Declaration of interest Funded by H. Lundbeck A/S.