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, ≥65 years, with unipolar major depression (DSM—IV: 296.2 × or 296.3 ×) and Montgomery—Asberg Depression Rating Scale score ≥22 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.