NR478
Tuesday, May 24, 3:00 p.m.-5:00 p.m.

Efficacy of Duloxetine for Anxiety in Elderly Patients With Major Depressive Disorder

Joel Raskin, M.D., Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285; Curtis Wiltse, Ph.D., Daniel Walker, Ph.D., James Russell, M.D., Olga Brawman-Mintzer, M.D.

Educational Objectives:
At the conclusion of this presentation, the participant should be able to recognize that MDD with comorbid anxiety is common in elderly patients and that duloxetine 60mg once daily is efficacious in reducing anxiety symptoms in these patients.

Summary:
Objective: To compare the efficacy of duloxetine 60mg once daily versus placebo in treating anxiety symptoms in elderly patients (>65) with MDD.
Methods: Patients were randomized to eight weeks of treatment with duloxetine 60mg (n=207) or placebo (n=104). Anxiety measures were analyzed for the total sample and by age, <75 (n=207) and >75 (n=96). Mean change from baseline to endpoint for HAMD17 items 10 (anxiety/psychic) and 11 (anxiety/somatic) and the anxiety/somatization subscale (items 10-13, 15, 17) were analyzed.
Results: Duloxetine produced greater reduction than placebo on item 10 (mean changed= -0.62 vs -0.18, p<.001) and the anxiety/somatization subscale (mean change= -1.88 vs -0.99, p=.002) but not item 11. Repeated measures analyses showed separation between duloxetine and placebo beginning at week 1 for item 10 and week 4 for the anxiety/somatization subscale. Significant reduction in item 10 scores for the <75 (mean change = -0.63 vs -0.17, p=.002) and >75 (mean change = -0.61 vs 0.00, p=.007) age groups was observed in the duloxetine group versus placebo. Duloxetine significantly reduced anxiety/somatization subscale scores for the <75 group (mean change = -1.90 vs. -0.80, p=.003) but not the >75 group (mean change = -1.92 vs. -1.25, p=.312).
Conclusion: Duloxetine appears to be efficacious in treating anxiety symptoms in elderly patients with MDD.

References:
1. Dunner DL, Goldstein DJ, Mallinckrodt C, Lu Y, Detke MJ: Duloxetine in treatment of anxiety symptoms associated with depression. Depress Anxiety 2003; 18:53-61.
2. Lenze EJ, Pollock BG, Shear MK, Mulsant BH, Bharucha A, Reynolds CF 3rd: Treatment considerations for anxiety in the elderly. CNS Spectr 2003; 8(12 Suppl 3):6-13.