INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Int J Geriatr Psychiatry 2001; 16: 451±454. DOI: 10.1002/gps.461 A feasibility study of antidepressant drug therapy in depressed elderly patients with chronic obstructive pulmonary disease y Abebaw M. Yohannes 1 *, Martin J. Connolly 2 and Robert C. Baldwin 3 1 Lecturer, ManchesterSchool of Physiotherapy, ManchesterRoyal In®rmary, Manchester, UK 2 SeniorLecturer, Department of Geriatric Medicine, University of Manchester, Manchester Royal In®rmary, Manchester, UK 3 Consultant Psychiatrist, Department of Old Age Psychiatry, Manchester Royal In®rmary, Manchester, UK SUMMARY Objectives To examine the acceptability of ¯uoxetine in elderly depressed patients with chronic obstructive pulmonary disease COPD). Setting A university teaching hospital. Method Single-blinded open) study. One hundred and thirty-seven outpatients 69 male) with symptomatic irreversible, moderate to severe COPD were recruited. Major depression was diagnosed using the Geriatric Mental State Schedule. Quality of life was assessed by the Breathing Problems Questionnaire, physical disability by the Manchester Respiratory Activities of Daily Living Questionnaire and severity of depression using the Montgomery Asberg Depression Rating Scale. Exclusion criteria were: use of oral steroids within 6 weeks, acute or chronic confusion, known cancer and known psychosis. Results Fifty-seven patients 42%) 25 males) with a mean age of 72 years range 60±89 years) were depressed. Fourteen six male) agreed to undergo therapy with ¯uoxetine 20 mg/day for 6 months, while 36 72%) refused antidepressant drug therapy. Only seven subjects completed the trial; of these, four 57%) responded to ¯uoxetine therapy. Five subjects with- drew because of side-effects. Twenty-two of those who refused treatment 61%) agreed to be interviewed, and of these 19 86%) were still depressed. Conclusion Patient acceptance of ¯uoxetine was poor. The reasons for refusing treatment varied but were largely due to misapprehension by the patient. Untreated depression became chronic. Offering antidepressants to COPD patients with depression is not an effective strategy. Why this might be so is discussed. Copyright # 2001 John Wiley & Sons, Ltd. key words Ð old age; depression; antidepressant treatment; ¯uoxetine INTRODUCTION Depressive symptoms are common in patients with chronic obstructive pulmonary disease COPD) Light etal., 1985). Their prevalence in older patients with COPD is higher than that in patients with other disabling illnesses and far higher than that in healthy older people Yohannes et al., 1998a). They are asso- ciated with dif®culties in activities of daily living, impaired exercise tolerance, reduced quality of life and increased mortality Bosley et al., 1996; Weaver et al., 1997; Yohannes et al., 1998a). Antidepressant treatment is effective in depressed patients with phy- sical illness Gill and Hatcher, 1998) and the newer antidepressants may be effective and well tolerated in older frail ill elderly people Evans et al., 1997). Despite this, little is known about the treatment of depression with antidepressants in elderly patients with COPD. In the only double-blind study Light Received 28 October 1999 Copyright # 2001 John Wiley & Sons, Ltd. Accepted 9 February 2000 *Correspondence to: Mr A. Yohannes, Manchester School of Physiotherapy, Manchester Royal In®rmary, Manchester M13 9WL, UK. Tel: +44-0)161-276-6641. Fax: +44-0)161-276-8711. E-mail: ayohanne@fs1.cmht.nwest.nhs.uk y Due to an unfortunate series of events, the paper `Depression and Anxiety in Elderly Outpatients with Chronic Obstructive Pulmon- ary Disease: Prevalence and Validation of the BASDEC Screening Questionnaire' by Yohannes AM, Baldwin RC and Connolly MJ, 1512): 1090±1096), intended for publication in JAGS, appeared in the December 2000 issue of the International Journal of Geriatric Psychiatry in place of this paper. The editor apologises for this mistake.