In a recent publication in the Journal of Psychiatric Research, researchers utilized participant-level data from large, NIH-sponsored trials in individuals with MDD aged 12 to 74 years to gain a better understanding of the impact of age on response to antidepressant treatment.

The data for this study were obtained from three NIH-sponsored trials of pharmacotherapy (Treatment of SSRI-Resistant Depression in Adolescents [TORDIA] Study, Treatment of Adolescent Depression Study [TADS], and the Combining Medications to Enhance Depression Outcomes Study [COMED] in patients with MDD).

The study involved 907 participants with an average age of 29.7 ± 17 years, 66.3% were women, and participants had a mean baseline Clinical Global Impression-Severity [CGI-S] score of 4.6 ± 0.9.

The results revealed that patients aged 21 years and younger and those aged older than 55 years had slower and less response to pharmacotherapy compared with those aged 21 to 35 years. Furthermore, women improved more than men, and this effect did not vary across ages.

Key highlights included that age considerably influences response to therapy in patients with MDD, and antidepressant treatment response is less responsive among younger and older patients.

The authors indicated this was the first study to assess how antidepressant treatment response differs across age groups. They also advised that in younger and older individuals, clinicians should utilize approaches to expand treatment that may be critical to enhance responses to antidepressant therapy. For example, the authors indicated that among individuals aged 21 to 35 years, “monotherapy or combinatorial antidepressant treatment” may be an appropriate early-stage approach.

With regard to lesser robust responses observed in older patients, the authors indicated that factors such as greater systemic inflammation, physiological changes due to aging, presence of more chronic conditions, or unique psychosocial stressors might affect response to treatment.

They concluded, “Treatment planning for younger and older participants with depression may need to include specific strategies to boost ‘antidepressant response.’ However, whether improving response in these age groups would be best accomplished by early psychotherapy, adjunctive treatments, or other interventions remains to be determined.”

Lastly, they noted that with regard to gender, women appear to improve more than men across the lifespan, implying that clinicians should consider multimodal measures for treating depression in men at earlier stages.

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