UNMC Researchers Seek People 75 Years and Older for
Nationwide Study on Depression Treatment
The University of Nebraska Medical Center Department of Psychopharmacology
is seeking 20 adults age 75 and older who may be experiencing depression
and are not currently on medication and want relief. Researchers are conducting
a study they hope will lead to better understanding of the effects of the
treatment of depression in older adults.
The research will compare the effectiveness of the anti-depressant,
citalopram hydrobromide, to a placebo in treating depression. Citalopram
is prescribed around the world as an effective anti-depressant and is thought
to be a safer anti-depressant for older adults.
UNMC is one of 10 universities in the country chosen to conduct the
8-week, 200-patient study funded by Forest Pharmaceuticals. UNMC will receive
a $150,000 grant. The research will be the first to evaluate whether adults
over 75 years old respond to typical anti-depression drug treatment.
Anti-depressants havent been well-studied in people 75 and older.
We believe they work but we dont know if its the medication or the counseling
and increased attention by family, said William Burke, M.D., professor
and director of the UNMC Psychopharmacology Research Center. As mental
health professionals, we assume anti-depressants work for persons of all
ages but we dont know for sure.
Depression has a profound effect on daily function. It can lead to physical
and mental disability, increased number of days in bed, more visits to
health providers and a decrease in enjoyment of life. It also is associated
with increased mortality and suicide.
The hallmark symptoms of depression usually include four of the following
changes for a minimum of two to four weeks: sleep disturbance, decreased
energy, appetite, concentration and an increase in restlessness, anxiety
and guilt, as well as a decreased interest in activities and suicidal ideas.
The study also will evaluate whether other prescriptions for health
conditions taken by study participants alter the effectiveness of the anti-depressant
or cause depression. The study also will use magnetic resonance imaging
(MRI) to look for evidence of physical changes in the brain that might
be causing depression.
We want to know what is the best way of treating people in this age
group, Dr. Burke said. We want to know if medications help and how much
they help. If they dont help, we have to look at other forms of treatment
such as education and psychotherapy or talk therapy.
Its important to understand depression in the older adult. Theres
some evidence there are different causes of depression for older adults.
For example, we suspect there are vascular changes in the brain that may
be involved. Also, persons with Alzheimers disease, Parkinsons disease
and stroke all seem to have an increased risk of depression. We believe
this is due to changes in the brain caused by those diseases. We want to
better understand the association.
Researchers also want to know if particular chemicals in other medications
taken for physical health conditions seen in older adults can cause depression.
The top 20 medications taken by older adults dont have a lot of properties
that affect memory and mood, Dr. Burke said. But four, five or six drugs
in combination could be blocking normal brain function, causing depression.
Evidence suggests people over 75 years old who are healthy and live
in their own home have the lowest depression rate of any age group. On
the other hand, those who are in ill-health and live in a nursing home,
assisted living or are in the hospital have a 30 to 50 percent rate of
depression.”
Dr. Burke said he and researchers expect up to one-third of the people
taking placebos in the study to get relief from their depression due to
social interaction and regular visits.
UNMC and the other 10 centers involved in the study were chosen for
their ability to work with older people with depression, Dr. Burke said.
We are flattered to be included in this group. Weve been doing this a
long time. Many of our staff have more than 10 years of experience and
have developed considerable expertise to benefit our patients.
The other centers are Harvard University, Yale University, Duke University,
Cornell University, St. Louis University, Brown University, University
of Pittsburgh, Columbia University, University of Pennsylvania, and the
University of California Los Angeles.
Eligible study participants should be in reasonably good health, not
currently on anti-depressants and not have Alzheimers disease. Potential
candidates will receive evaluations, clinic visits, blood draws and an
MRI. Participants accepted into the study will be offered free treatment
following the study.
People ages 75 and older who are currently experiencing depression,
as well as those who think they are experiencing depression can call UNMC
at (402) 559-5056 for more information about the study. Callers can be
screened over the phone if they think they are experiencing depression.
UNMC is the only public academic health science center in the state.
Through its commitment to research, education, outreach and patient care,
UNMC has established itself as one of the country’s leading centers for
cancer research and treatment, solid organ transplantation and arthritis.
During the past year, nearly $31 million in research grants and contracts
were awarded to UNMC scientists, and UNMCs funding from the National Institutes
of Health increased by 28 percent, going from $16.2 million to $20.7 million.
UNMCs educational programs are responsible for training more health professionals
practicing in Nebraska than any other institution.