| Duloxetine and care management treatment of older adults with comorbid major depressive disorder and chronic low back pain: results of an open-label pilot study. | |
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MedLine Citation:
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PMID: 19750557 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: In older adults, major depressive disorder (MDD) and chronic low back pain (CLBP) are common and mutually exacerbating. We predicted that duloxetine pharmacotherapy and Depression and Pain Care Management (DPCM) would result in (1) significant improvement in MDD and CLBP and (2) significant improvements in health-related quality of life, anxiety, disability, self-efficacy, and sleep quality. DESIGN AND INTERVENTION: Twelve week open-label study using duloxetine up to 120 mg/day + DPCM. SETTING: Outpatient late-life depression research clinic. PATIENTS: Thirty community-dwelling adults >60 years old. OUTCOME MEASURES: Montgomery Asberg Depression Rating Scale (MADRS) and McGill Pain Questionnaire-Short Form (MPQ-SF). RESULTS: 46.7% (n = 14) of the sample had a depression remission. All subjects who met criteria for the depression remission also had a pain response. 93.3% (n = 28) had a significant pain response. Of the subjects who met criteria for a low back pain response, 50% (n = 14) also met criteria for the depression remission. The mean time to depression remission was 7.6 (SE = 0.6) weeks. The mean time to pain response was 2.8 (SE = 0.5) weeks. There were significant improvements in mental health-related quality of life, anxiety, sleep quality, somatic complaints, and both self-efficacy for pain management and for coping with symptoms. Physical health-related quality of life, back pain-related disability, and self-efficacy for physical functioning did not improve. CONCLUSIONS: Serotonin and norepinephrine reuptake inhibitors like duloxetine delivered with DPCM may be a good choice to treat these linked conditions in older adults. Treatments that target low self-efficacy for physical function and improving disability may further increase response rates. |
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Authors:
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Jordan F Karp; Debra K Weiner; Mary A Dew; Amy Begley; Mark D Miller; Charles F Reynolds |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: International journal of geriatric psychiatry Volume: 25 ISSN: 1099-1166 ISO Abbreviation: Int J Geriatr Psychiatry Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-17 Completed Date: 2011-01-26 Revised Date: 2012-10-09 |
Medline Journal Info:
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Nlm Unique ID: 8710629 Medline TA: Int J Geriatr Psychiatry Country: England |
Other Details:
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Languages: eng Pagination: 633-42 Citation Subset: IM |
Affiliation:
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Advanced Center for Intervention and Services Research for Late Life Mood Disorders, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. karpjf@upmc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anxiety / epidemiology Chronic Disease Comorbidity Depressive Disorder, Major / drug therapy*, psychology Disability Evaluation Disease Management Female Health Status Humans Low Back Pain* / diagnosis, psychology Male Pain Measurement Pilot Projects Psychiatric Status Rating Scales Quality of Life Questionnaires Self Efficacy Serotonin Uptake Inhibitors / therapeutic use* Sleep Thiophenes / therapeutic use* |
| Grant Support | |
ID/Acronym/Agency:
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KL2 RR-024154-03/RR/NCRR NIH HHS; KL2 RR024154/RR/NCRR NIH HHS; KL2 RR024154-04/RR/NCRR NIH HHS; P30 MH071944-05/MH/NIMH NIH HHS; P30 MH71944/MH/NIMH NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Serotonin Uptake Inhibitors; 0/Thiophenes; 116539-58-3/duloxetine |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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