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Antidepressant medication and executive dysfunction: a deleterious interaction in late-life depression.

OBJECTIVES
To determine whether there is differential response to placebo or citalopram among older patients with and without deficient response inhibition (DRI).


DESIGN
This is an 8-week, double-blind, placebo-controlled trial.


SETTING
Outpatient psychiatry.


PARTICIPANTS
Unipolar depressed patients aged 75 years and older.


INTERVENTION
Citalopram (20-40 mg/day) or placebo pill.


MEASUREMENTS
Baseline Stroop Color-Word Test and weekly 24-item Hamilton Rating Scale for Depression assessments.


RESULTS
Citalopram-treated patients with DRI did significantly worse than placebo-treated patients with DRI. Conversely, citalopram-treated patients without DRI did significantly better than placebo-treated patients without DRI.


CONCLUSION
Patients with late-life depression and DRI respond worse to selective serotonin reuptake inhibitor (SSRI) than placebo. These findings suggest that there may be a deleterious interaction between DRI and antidepressant medication in late-life depression and that the mechanism of SSRI and placebo response is different.