The fourth group received a placebo. They all were followed for three years. The results showed that the combination of nortriptyline and IPT prevented recurrence of depression in 80 percent of the patients, while medication alone prevented recurrence in 57 percent of the patients and IPT in 36 percent. Only 10 percent of patients in the placebo group remained well. These results are at odds with the way treatment standards are moving under managed care.
Most plans allow only medication or medication with limited therapy.
If our results hold true, combination therapy would not only be better for the patients, but save health care dollars in the long run. Depression in old age affects at least one in six people and an even higher percentage among those in hospitals and nursing homes. It has serious health consequences, including suicide, illness and increased health care costs to society. It was important for us to assess the major treatment strategies because some elderly patients may refuse to take medication and some have added stresses such as bereavement and role transitions to cope with. A long-term commitment by patients and their families is essential, and the unique bond Dr. Reynolds' researchers have formed with their patients encourages them to see the study through.