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Duloxetine for the Treatment of Recurrent Major Depressive Disorder in Elderly Patients: Treatment Outcomes in Patients With Comorbid Arthritis

Received August 22, 2006; revised July 19, 2007; accepted August 1, 2007. From Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, and the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA. Send correspondence and reprint requests to Madelaine M. Wohlreich, M.D., Eli Lilly and Company, Lilly Corporate Center, Drop Code 4103, Indianapolis, IN 46285. e-mail: mwmd{at}lilly.com
© 2009 The Academy of Psychosomatic Medicine

BACKGROUND: Evaluation and treatment of major depression (MDD) in elderly patients is frequently complicated by the presence of comorbid medical conditions, which can reduce the effect of depression treatment, leading to lower rates of depressive-symptom improvement and higher rates of relapse. OBJECTIVE: The authors investigated results of antidepressant concurrent with arthritis pain treatment in elderly patients. METHOD: Patients age 65 and over with recurrent MDD were stratified by arthritis status and randomized to duloxetine (a dual reuptake-inhibitor of serotonin and norepinephrine) or placebo treatment for 8 weeks (duloxetine, N=117; placebo, N=55). RESULTS: Duloxetine significantly reduced MDD symptom severity in elderly patients with and without arthritis, and produced significant reduction in several pain measures in those patients with comorbid arthritis. DISCUSSION: The magnitude and time-course of depressive symptom improvement did not differ significantly between patients with and without arthritis. Some studies have suggested that the severity of pain in arthritis patients may be linked to depression severity.

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