Treatment of Bereavement-Related Major Depressive Episodes in Later Life: A Controlled Study of Acute and Continuation Treatment With Nortriptyline and Interpersonal Psychotherapy

Abstract

Objective: The authors tested the hypothesis that nortriptyline and interpersonal psychotherapy, alone and in combination, are superior to placebo in achieving remission of bereavement-related major depressive episodes. Method: Eighty subjects, aged 50 years and older, with major depressive episodes that began within 6 months before or 12 months after the loss of a spouse or significant other were randomly assigned to a 16-week double-blind trial of one of four treatment conditions: nortriptyline plus interpersonal psychotherapy (N=16), nortriptyline alone in a medication clinic (N=25), placebo plus interpersonal psychotherapy (N=17), or placebo alone in a medication clinic (N=22). The protocol required that the acute-phase double-blind treatment be ended after 8 weeks if Hamilton depression scale ratings had not improved by 50%. Remission was defined as a 17-item Hamilton scale score of 7 or lower for 3 consecutive weeks. Results: The rate of remission for nortriptyline plus interpersonal psychotherapy w...