June 14, 2007
Many studies document the benefit of augmented antidepressant therapy, but few have tested it in the elderly. A new trial reported in the current American Journal of Psychiatry offered a second antidepressant to patients over age 70 who did not respond well to initial treatment with paroxetine (Paxil). About half who took the second drug recovered (and two-thirds of those so treated after a relapse).
An editorial accompanying the study report observes that over a third of patients in the study were either unwilling or unable to take the second drug, which are often contraindicated in light of coexisting medical conditions. Because of medical comorbidities, it laments, “our hands are tied“ in caring for this population.
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Evidence-Based Articles and Meta-Analyses
“Remarkably“, the editorial says, augmented antidepressant treatment appears to work just as well among elderly patients in the new trial as it did among younger adults in the recently concluded STAR*D study.
Practice Guidelines
What do expert groups advise about treatment of depression in older adults with comorbidities?
Practical Articles & News
Bring yourself up to date on clinical practice advice about depression treatment in the elderly.
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Depression | Tagged: paroxetine | 
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Posted by Cranky Aged Mama
June 7, 2007
A Cleveland Clinic team brewed a storm when their meta-analysis of 42 placebo-controlled studies involving rosiglitazone turned up a significantly increased risk of myocardial infarction and an increase of “borderline significance” in cardiovascular deaths. An accompanying editorial in the New England Journal of Medicine questions whether the drug was approved and used too soon, on the basis of a mere secondary effect (lowering blood glucose). Another in the Lancet urges doctors to wait for further evidence before leaping to judgment.
Is this the letdown after a happy fantasy? Only six months ago, the results of the aptly named DREAM trial were prompting suggestions that the drug might prevent type 2 diabetes.
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Practical Articles and News
In the news category, you can find the safety alert that the Food and Drug Administration swiftly issued in response to the new study.
Evidence-based Articles and Meta-analyses
Critics argue that the FDA approved the drug without sufficient evidence of benefit regarding primary outcomes such as mortality. What does evidence-based research show about the effects of rosiglitazone?
Clinical Trials for Patients
Learn what clinical trials now underway may provide new information about the use of this drug.
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Cardiovascular, Diabetes_Endocrine | Tagged: Cleveland Clinic, rosiglitazone | 
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Posted by Cranky Aged Mama
Posted by Cranky Aged Mama
