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Minocycline augmentation in older adults with persistent depression: an open label proof of concept study

Published online by Cambridge University Press:  21 July 2020

Jimmy N. Avari ,
Dora Kanellopoulos ,
Nili Solomonov ,
Lauren Oberlin  and
George S. Alexopoulos
Jimmy N. Avari*
Affiliation:
Weill-Cornell Institute of Geriatric Psychiatry, 21 Bloomingdale Road, White Plains, NY, USA
Dora Kanellopoulos
Affiliation:
Weill-Cornell Institute of Geriatric Psychiatry, 21 Bloomingdale Road, White Plains, NY, USA
Nili Solomonov
Affiliation:
Weill-Cornell Institute of Geriatric Psychiatry, 21 Bloomingdale Road, White Plains, NY, USA
Lauren Oberlin
Affiliation:
Weill-Cornell Institute of Geriatric Psychiatry, 21 Bloomingdale Road, White Plains, NY, USA
George S. Alexopoulos
Affiliation:
Weill-Cornell Institute of Geriatric Psychiatry, 21 Bloomingdale Road, White Plains, NY, USA
*
Correspondence should be addressed to: Jimmy N. Avari, Weill-Cornell Institute of Geriatric Psychiatry, 21 Bloomingdale Road, White Plains, NY, USA. Phone: +1 914-997-5867; Fax: +1 914-682-6979. Email: jia9010@med.cornell.edu
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Abstract

Less than 40% of depressed older adults treated with an antidepressant achieve remission. Incomplete response to treatment is common. Current augmentation strategies have limited efficacy, and many have side effects that restrict their utilization in older adults. We conducted the first open pilot trial of minocycline augmentation in older adults who had failed to achieve remission after adequate psychopharmacologic treatment. Subjects older than 55 years of age with major depression and failure to achieve substantial improvement of depressive symptoms after at least 6 weeks of antidepressant treatment were given augmentation with minocycline 100 mg twice daily over an 8-week period. At the end of 8 weeks of augmentation with minocycline, 31% (4/13) patients achieved remission. Remitters had higher baseline ratings of hopelessness and apathy. Minocycline was well tolerated with no reported adverse events or discontinuation due to intolerance. Larger placebo-controlled studies are needed to evaluate the effects of minocycline augmentation in older adults who had failed to achieve remission after adequate treatment with antidepressants.

Keywords

antidepressantbipolar disorderinflammationmajor depressive disorderanti-inflammatory
Type
Brief Report
Information
International Psychogeriatrics , Volume 32 , Issue 7: Issue Theme: Sleep and Sleep Disorders in Older Adults , July 2020 , pp. 881 - 884
Copyright
© International Psychogeriatric Association 2020

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