Metabolic Syndrome in Older Adults Associated With Resistance to Depression Treatments

A study published in the Journal of the American Geriatrics Society found older adults with metabolic syndrome have more severe symptoms and chronicity of depression, and take longer to respond to antidepressant drugs, reports Healio . A secondary analysis of a randomized controlled trial involved 435 adults aged 60 years or older with major depressive disorder who were taking extended-release venlafaxine for at least 12 weeks. If a participant's depression levels remained high after six weeks of medication, they received a higher dose. The outcomes showed 222 participants had metabolic syndrome at baseline, and they also exhibited greater severity and chronicity of depression. A total of 182 participants had remission of depression. Those with metabolic syndrome experienced a longer time to remission, but this association was not significant in the adjusted analysis. Diastolic BP was the only significant predictor of time to remission in both the adjusted and unadjusted analysis, and participants with a higher diastolic BP were more likely to have longer time to remission. Time to remission could not be forecast by insulin sensitivity. "The results of this study should be interpreted with caution," the researchers note. "We do not recommend that clinicians treat older adults with depression differently in the face of co-occurring metabolic syndrome. Further verification of these findings is indicated using more reliable markers of insulin resistance and other classes of antidepressants in racially diverse populations in the hopes of better informing treatment decisions in late-life depression."