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Nine of 15 elderly male VA outpatients receiving long-term tricyclic antidepressant therapy underwent gradual placebo substitution under double-blind conditions. Three of the 9 (33.3%) experienced a reoccurrence of depressive symptoms on placebo (at 4, 5 and 6 months). None of the 6 remaining on active medication experienced a reoccurrence. The Hamilton Depression Scale and Montgomery Asberg Depression Rating Scale scores indicate a significantly (P less than 0.05) worse outcome for those switched to placebo. The results suggest the need for close follow-up after discontinuation of antidepressant therapy in this population.
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