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Treatment of depression associated with age-related macular degeneration: A double-blind, randomized, controlled study

Barbara L. Brody, MPH

Department of Ophthalmology, Department of Family and Preventive Medicine (SDE, Division of Biostatistics), University of California, San Diego, La Jolla, CA, USA

Linda C. Field, MA

Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA

Anne-Catherine Roch-Levecq, PhD

Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA

Christine Y. Moutier, MD

Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA

Steven D. Edland, PhD

Department of Family and Preventive Medicine (SDE, Division of Biostatistics), Department of Neuroscience, University of California, San Diego, La Jolla, CA, USA

Stuart I. Brown, MD

Department of Ophthalmolog, University of California, San Diego, La Jolla, CA, USA

BACKGROUND: Depression is frequently found in patients with age-related macular degeneration (AMD). The purpose of this study was to assess the effectiveness of escitalopram in treating major and minor depression in AMD patients.

METHODS: We conducted a crossover, randomized, double-blind, placebo-controlled, 16-week study comparing escitalopram with placebo. Inclusion criteria included reduced vision from AMD and major or minor depression, with a 17-item Hamilton Rating Scale for Depression (HAMD-17) score of ≥10. Participants were randomly assigned to receive either escitalopram or placebo for 8 weeks and then crossed over to the other treatment. The primary outcome was change on the total HAMD-17 score with escitalopram treatment compared with placebo.

RESULTS: We enrolled 16 AMD patients (mean age 79.1), 12 with major depression and 4 with minor depression. Mean HAMD-17 score at enrollment was 16.1 ± 4.2, and mean visual acuity in the better eye was 20/70. During escitalopram treatment, participants showed a significant reduction in HAMD-17 scores compared with placebo treatment (P = .01).

CONCLUSIONS: These findings suggest escitalopram may be an effective treatment for depressive symptoms associated with major or minor depression in AMD patients with vision loss.

KEYWORDS: age-related macular degeneration, major depression, minor depression, escitalopram, crossover trial

ANNALS OF CLINICAL PSYCHIATRY 2011;23(4):277-284

CORRESPONDENCE: Christine Y. Moutier, MD, UCSD School of Medicine, 9500 Gilman Drive, La Jolla, CA 92161 USA, E-MAIL: cmoutier@ucsd.edu
Annals of Clinical Psychiatry ©2011 Quadrant HealthCom Inc.

 
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