To examine the effect of older versus younger age on change in anthropometric and
metabolic measures during extended treatment of psychotic depression with sertraline
Two hundred and sixty-nine men and women aged 18–85 years with an episode of psychotic
depression were treated with open-label sertraline plus olanzapine for up to 12 weeks.
Participants who remained in remission following an 8-week stabilization phase were
eligible to participate in a 36-week randomized controlled trial (RCT) that compared
the efficacy and tolerability of sertraline plus olanzapine with sertraline plus placebo.
Weight, waist circumference and plasma lipids, glucose, HbA1c, and insulin were measured
at regular intervals during the acute, stabilization and randomized phases of the
study. Linear mixed models were used to analyze the trajectories of anthropometric
and metabolic measures.
Participants aged 60 years or older experienced less weight gain and less increase
in cholesterol during the combined acute and stabilization phases of the study compared
with those aged 18–59 years. At the acute-stabilization termination visit, mean weight
in older participants was 6.5 lb. less than premorbid weight, whereas it was 17.9
lb. more than premorbid weight in younger participants. In the RCT, there was a significant
interaction of treatment and age group for the trajectory of weight, but the post
hoc tests that compared age groups within each treatment arm were not statistically
significant. There were no clinically significant differences between younger and
older participants in glycemic measures.
Older patients with psychotic depression experienced less increase in weight and total
cholesterol than their younger counterparts during acute and stabilization treatment
with sertraline plus olanzapine. In the older group, weight gained during the acute
and stabilization phases appeared to be partial restoration of weight lost during
the index episode of depression, whereas weight gain in younger participants was not.