Complementary Use of Tai Chi Chih Augments Escitalopram Treatment of Geriatric Depression: A Randomized Controlled Trial

• Published in: The American journal of geriatric psychiatry Vol. 19; no. 10; pp. 839 - 850
• Main Authors: Lavretsky, Helen, Alstein, Lily L., Olmstead, Richard E., Ercoli, Linda M., Riparetti-Brown, Marquertie, St. Cyr, Natalie, Irwin, Michael R.
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.10.2011; Elsevier Limited
• Subjects: Aged; Anxiety - complications; Anxiety - psychology; C-Reactive Protein - metabolism; Citalopram - therapeutic use; Cognition; Cognition - drug effects; Combined Modality Therapy - methods; Combined Modality Therapy - psychology; Depressive Disorder, Major - metabolism; Depressive Disorder, Major - psychology; Depressive Disorder, Major - therapy; escitalopram; Female; geriatric depression; Health Education - statistics & numerical data; Humans; Internal Medicine; Male; Psychiatric Status Rating Scales - statistics & numerical data; quality of life; Quality of Life - psychology; resilience; Resilience, Psychological - drug effects; Severity of Illness Index; Tai Chi Chih; Tai Ji - psychology; treatment response; geriatric depression; Tai Chi Chih; treatment response; escitalopram; Cognition; quality of life; resilience
• ISSN: 1064-7481; 1545-7214; 1545-7214
• DOI: 10.1097/JGP.0b013e31820ee9ef

Nearly two-thirds of elderly patients treated for depression fail to achieve symptomatic remission and functional recovery with first-line pharmacotherapy. In this study, we ask whether a mind–body exercise, Tai Chi Chih (TCC), added to escitalopram will augment the treatment of geriatric depression designed to achieve symptomatic remission and improvements in health functioning and cognitive performance. One hundred twelve older adults with major depression age 60 years and older were recruited and treated with escitalopram for approximately 4 weeks. Seventy-three partial responders to escitalopram continued to receive escitalopram daily and were randomly assigned to 10 weeks of adjunct use of either 1) TCC for 2 hours per week or 2) health education (HE) for 2 hours per week. All participants underwent evaluations of depression, anxiety, resilience, health-related quality of life, cognition, and inflammation at baseline and during 14-week follow-up. Subjects in the escitalopram and TCC condition were more likely to show greater reduction of depressive symptoms and to achieve a depression remission as compared with those receiving escitalopram and HE. Subjects in the escitalopram and TCC condition also showed significantly greater improvements in 36-Item Short Form Health Survey physical functioning and cognitive tests and a decline in the inflammatory marker, C-reactive protein, compared with the control group. Complementary use of a mind–body exercise, such as TCC, may provide additional improvements of clinical outcomes in the pharmacologic treatment of geriatric depression.