Difficult to treat depression is very common among older adults and takes a considerable toll on their quality of life and may increase their risk of developing dementia, feelings of loneliness, serious falls, worsening of other medical conditions and earlier death.
“Depressed older adults often see little benefit from the medications that we typically use to treat depression,” said Jordan F. Karp, M.D.
, associate professor of psychiatry, anesthesiology, and clinical and translational science at Pitt’s School of Medicine, and lead researcher of the Pittsburgh study site. “At least 50 percent of older adults don’t respond to their existing antidepressant medications and we don’t yet know what the safe and effective treatment options are for these patients. Older adults likely respond differently to medications than younger people, and this study will break new ground by identifying those differences and finding better treatment options that may improve their quality of life.”
Participants in the OPTIMUM study will either be switched to a new drug or have a drug added to their existing antidepressant medication regimen. For those who still do not respond to treatment, they may switch to a different medication.
In addition to comparing the clinical benefits of these treatments, the researchers also will explore how aging-related factors, such as cognitive changes and medical illnesses, affect the benefits and risks of these different antidepressant strategies.
The Pittsburgh study site aims to recruit 300 participants aged 60 and older. Participants also will receive phone-based assessments from the research team who will provide simple recommendations and will collaborate with each patient’s primary care physician or psychiatrist.
According to Dr. Reynolds, “It’s normal to be concerned about maintaining brain health and independence as you age. A way to preserve these functions and keep people more active and healthy in their community is to reduce risks factors. By finding ways to treat difficult depression, we can reduce a potent risk factor for many of these concerns that plague older adults.”
OPTIMUM will last five years, and is a collaboration among researchers at Pitt’s School of Medicine, Washington University School of Medicine in St. Louis, the David Geffen School of Medicine at UCLA, the University of Toronto School of Medicine, and Columbia University.