Celecoxib or Naproxen Treatment Does Not Benefit Depressive Symptoms in Persons Age 70 and Older: Findings From a Randomized Controlled Trial
The American Journal of Geriatric Psychiatry, 05/29/2012
Fields C et al. – Treatment with celecoxib or naproxen did not improve depressive symptoms over time compared with placebo. While inflammation has been implicated in late–life depression, these results do not support the hypothesis that inhibition of the cyclooxygenase pathway with these nonsteroidal anti–inflammatory drugs at these doses alleviates depressive symptoms in older adults.Methods
- The Alzheimer's Disease Anti-inflammatory Prevention Trial was a randomized, placebo-controlled, double-masked clinical trial conducted at six U.S. memory clinics.
- Cognitively normal volunteers age 70 and older with a family history of Alzheimer-like dementia were randomly assigned to receive celecoxib 200 mg twice daily, naproxen sodium 220 mg twice daily, or placebo.
- The 30-item version of the Geriatric Depression Scale (GDS) was administered to all participants at enrollment and at yearly follow-up visits.
- Participants with a GDS score greater than 5 at baseline were classified as depressed.
- Of 2,528 participants enrolled, 2,312 returned for at least one follow-up visit.
- Approximately one-fifth had significant depressive symptoms at baseline.
- Mean GDS score, and the percentage with significant depressive symptoms, remained similar over time across all three treatment groups.
- Furthermore, there was no treatment effect on GDS scores over time in the subgroup of participants with significant depressive symptoms at baseline.
- In longitudinal analysis using generalized estimating equations (GEE) regression, higher baseline GDS scores, a prior psychiatric history, older age, time in the study, and lower cognition interacting with time, but not treatment assignment, were associated with significantly higher GDS scores over time.