Refractory depression in late life: a review of treatment options

Rc, Baldwin

doi:10.1017/s0959259800002367

Cited by 9 publications

(5 citation statements)

References 35 publications

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“…Although antidepressants have been well established as the first line of effective treatment for LLD, up to one‐third of patients with LLD show a suboptimal response or resistance to antidepressant therapy . Furthermore, their efficacy in addressing depression‐related cognitive deficits remains questionable.…”

Section: Introductionmentioning

confidence: 99%

High‐definition transcranial direct current stimulation—An open‐label pilot intervention in alleviating depressive symptoms and cognitive deficits in late‐life depression

et al. 2019

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The efficacy of high‐definition transcranial direct current stimulation (HD‐tDCS) in late‐life depression (LLD) remains unknown due to limited research on its therapeutic effects on the hallmarks of LLD—the depressive and cognitive symptoms. The present open‐label pilot study aimed to examine the effectiveness of HD‐tDCS as an augmentation therapy with antidepressants in improving the depressive and cognitive symptoms for LLD. Significant improvements were hypothesized in the depressive, cognitive, and daily functioning outcomes over time. A total of 15 subjects with LLD (13 females, mean age = 73.27 ± 6.25) received five consecutive daily sessions of 20‐minute active HD‐tDCS interventions weekly for 2 weeks, with a 2 mA anodal stimulation over F3 and cathodal stimulation over FC1, AF3, F7, and FC5. Depressive symptoms and cognitive and daily functioning were assessed across five assessment timepoints. The results revealed that the HD‐tDCS was effective in reducing the depressive severity and the remission rates, with a sustained effect at both the 1‐month and 3‐month follow‐up. Pre‐post improvements were seen in the overall cognitive functioning and in verbal fluency, but not in executive functioning. Our pilot study provides a preliminary result of HD‐tDCS in LLD, which was a safe and effective treatment in alleviating depressive symptoms, with mild cognitive improvements observed. Further larger scale randomized controlled trials are needed to confirm this result.

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Section: Introductionmentioning

confidence: 99%

High‐definition transcranial direct current stimulation—An open‐label pilot intervention in alleviating depressive symptoms and cognitive deficits in late‐life depression

et al. 2019

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“…Treatment-resistant late-life depression (TRLLD) is a common problem where up to one third of patients are affected [9, 10]. Further, the elderly are more likely to experience relapses and recurrences than younger adults [11–13].…”

Section: Introductionmentioning

confidence: 99%

A Review of Brain Stimulation Treatments for Late-Life Depression

Blumberger

Hsu

Daskalakis

2015

Curr Treat Options Psych

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Opinion Statement Recurrence, relapse and resistance to first-line therapies are common and pervasive issues in the treatment of depression in older adults. As a result, brain stimulation modalities are essential treatment options in this population. The majority of data for the effectiveness of brain stimulation modalities comes from electroconvulsive therapy (ECT) studies. Current ECT trials are focused on prolonging response after a successful course and mitigating the cognitive adverse effects. Newer forms of brain stimulation have emerged; unfortunately, as with most advances in medicine older adults have not been systematically included in clinical trials. Repetitive transcranial magnetic stimulation has demonstrated efficacy in younger adults and there is emerging data to support its use in late-life depression (LLD). It will be imperative that older adults be included in future transcranial direct current stimulation and magnetic seizure therapy clinical trials. Unclear efficacy results are a concern for both vagus nerve stimulation and deep brain stimulation.

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“…Venlafaxine showed some promise in resistant depression but evaluation is mostly confined to clinical experience (Bowskill and Bridges, 1997), or open trials (Nierenberg et al, 1994). It has been estimated that the overall success rate for class switching is about 50% (Baldwin, 1996).…”

Section: Switching Antidepressant Classmentioning

confidence: 99%

Pharmacological treatment of depression in older people

Curran¹,

Byrne²,

Wattis³

2006

MHLDRP

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In the light of recent National Institute for Clinical Excellence (NICE) and Committee for the Safety of Medicines (CSM) guidance we discuss the importance of the diagnosis of depression in old age and review pharmacological interventions. An introductory section is followed by sections on each of the main antidepressant groups. This briefly describes their pharmacology and reviews research done specifically relevant to older people. Finally practical clinical applications are discussed.

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Refractory depression in late life: a review of treatment options

Cited by 9 publications

References 35 publications

High‐definition transcranial direct current stimulation—An open‐label pilot intervention in alleviating depressive symptoms and cognitive deficits in late‐life depression

High‐definition transcranial direct current stimulation—An open‐label pilot intervention in alleviating depressive symptoms and cognitive deficits in late‐life depression

A Review of Brain Stimulation Treatments for Late-Life Depression

Pharmacological treatment of depression in older people

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