Poster Number: EI 13 - Continuation Treatment of Remitted Psychotic Depression: The STOP-PD Study

Abstract

Introduction: Psychotic depression (PD) is a severe disorder with high levels of morbidity and mortality. It is particularly relevant to the geriatric population, occurring in up to 45% of depressed elderly inpatients. Treatment guidelines recommend either electroconvulsive therapy (ECT) or the combination of antidepressant and antipsychotic medications as acute treatment. There are, however, few data pertaining to the efficacy and tolerability of continuation treatment of PD. Some naturalistic studies report a high frequency of relapse of PD, which may be partly explained by switching from acute ECT to continuation pharmacotherapy; in prospective open-label studies, when PD patients are continued on the treatment that is associated with remission the rate of relapse is lower. Given the paucity of research in this area, we conducted a 12-week double-blind study of continuation pharmacotherapy in persons who had experienced remission of PD in a double-blind RCT comparing the efficacy and tolerability of olanzapine plus sertraline (combination therapy) with olanzapine plus placebo (monotherapy) in adults aged 18 years and older (the STOP-PD study). The specific aims of this continuation study were to examine whether combination therapy and monotherapy differed in: i) stability of remission of depressive and psychotic symptoms; ii) frequency of relapse; and iii) course of weight, serum lipids, and serum glucose. Given the predominantly older age of participants, we examined whether there was an interaction between age, treatment, and outcome.