Treatment of geriatric depression

Abstract

The author reviews clinical issues regarding the treatment of late-life depression. Accurate diagnosis is complicated by the presence of medical illness, dementia syndromes, and heterogeneity of patient populations. Older depressed patients are often sensitive to drug toxicity resulting from age-related pharmacokinetic changes and polypharmacy. Thus, modification in the use of antidepressant drugs is needed to avoid side effects. Numerous antidepressant drugs are safe and efficacious in elderly depressed patients, and newer agents such as the selective serotonin reuptake inhibitors are often preferred over tricyclic antidepressants because of side effect profiles. Nonpharmacological approaches, alone and in combination with antidepressant drugs, are also useful, and maintenance treatments appear to reduce the likelihood of relapse.

Deciphering the 4 D's: cognitive decline, delirium, depression and dementia – a review

“…Depression is not a single disorder, but a heterogeneous group of disorders with differing severity. Clinicians can use the mnemonic device, SIG E CAPS, to remember symptoms of depression: sleep disturbance, lack of interest, guilt, reduced energy, difficulty concentrating, appetite changes, psychomotor disturbances, and suicide (Small 1998, 2000). Major symptoms of depression, lack of concentration or memory deficits, are relevant to this discussion because these symptoms are often confused with dementia.…”

“…Treatment of depression can be divided into nonpharmacological and pharmacological approaches (Small 1998). Nonpharmacological approaches must ensure that the psychosocial needs of older adults are being met.…”