Treatment resistant depression in the elderly

Bonner, Deirdre; Howard, Robert

doi:10.1002/gps.930100402

Cited by 13 publications

(5 citation statements)

References 30 publications

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“…In line with other reports (Musetti et al, 1989;Stage, 1997;Oxman et al, 1990;Rothschild, 1996), psychosis was not signi®cantly dierent. Contrary to other reports (Jenkins et al, 1996;Reynolds III et al, 1996;Kivela, 1995;Baldwin, 1995;Bonner and Howard, 1995), chronicity and recurrences were not signi®-cantly more common in late-life depression. Many reports support a subdivision of late-life depression into early-onset and late-onset subtypes.…”

Section: Discussioncontrasting

confidence: 83%

Late-life depression in private practice depressed outpatients: a 203-case study

Benazzi

1998

Int. J. Geriat. Psychiatry

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Objectives. To establish the prevalence of late‐life depression in unipolar/bipolar depressed outpatients in private practice, to compare it with depression in younger patients and to compare its early/late‐onset subtypes. Methods. Two hundred and three consecutive unipolar/bipolar depressed outpatients presenting for treatment of depression were interviewed with the Comprehensive Assessment of Symptoms and History structured interview and depression severity was assessed with the Montgomery and Asberg Depression Rating Scale and the Global Assessment of Functioning Scale. Results. Prevalence was 21%. Late‐life depression had significantly more unipolar/fewer bipolar patients, higher age at onset, longer duration of illness and lower psychiatric comorbidity than depression in younger patients. Severity, psychosis, chronicity and recurrences were not significantly different. Early‐onset late‐life depression had significantly lower age at baseline, longer duration of illness and more recurrences than late‐onset late‐life depression. Conclusions. Findings support suggested age subdivisions of depression and provide a picture of private practice late‐life depression. © 1998 John Wiley & Sons, Ltd.

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Section: Discussioncontrasting

confidence: 83%

Late-life depression in private practice depressed outpatients: a 203-case study

Benazzi

1998

Int. J. Geriat. Psychiatry

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“…Such barriers can be categorized as patient barriers, provider barriers, conceptual barriers, and policy/funding barriers. As discussed earlier, a number of studies have documented treatment resistance among depressed older adults (e.g., Baldwin & Simpson, 1997;Bonner & Howard, 1995;Flint, 1995;Kamholz & Mellow, 1996). Besides patient and provider barriers to using psychosocial interventions, there may also be conceptual barriers as well as barriers stemming from the interrelated issues of policy, funding, and the context of treatment.…”

Section: Resultsmentioning

confidence: 97%

Chapter 7; Depression and Anxiety

Adamek

Slater

2008

Journal of Gerontological Social Work

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“…However, early in treatment, patients, their family or clinicians may mistake these somatic symptoms for side effects. Unfortunately, this often leads to premature discontinuation of antidepressant medication (Bonner and Howard, 1995;Mulsant and Pollock, 1998). In PROSPECT, the health specialists assess somatic symptoms at baseline prior to initiation of treatment and during follow-up (longitudinally) (Raue et al, 2001).…”

Section: Management Of Patients Intolerant To Treatmentmentioning

confidence: 99%

Pharmacological treatment of depression in older primary care patients: the PROSPECT algorithm

Mulsant

Alexopoulos

Reynolds

et al. 2001

Int J Geriat Psychiatry

122

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PROSPECT (Prevention of Suicide in Primary care Elderly-Collaborative Trial) is testing whether a trained clinician (the 'health specialist') can work in close collaboration with a primary care physician to implement a comprehensive depression management program and improve outcomes in older depressed patients. An algorithm guiding the selection and use of antidepressant medications has been developed to assist PROSPECT health specialists. This algorithm is presented and the rationale underlying the proposed treatment sequence is discussed. The PROSPECT algorithm builds upon existing guidelines after updating them and adapting them to the special circumstances of older primary care patients. Special attention has been paid to the tolerability and the target doses of the recommended antidepressant agents and to the duration of antidepressant trials. Patients who are unable to tolerate or do not respond to an antidepressant can be switched to another agent or be treated with interpersonal psychotherapy. Agents that produce only a partial response can be combined with other antidepressants or with interpersonal psychotherapy. Treatments for which empirical evidence exists are favored. However, treatments that are often poorly tolerated by elderly patients are given lower priority than treatments more likely to be tolerated. Similarly, trials that are simpler to implement in primary care are favored.

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Treatment resistant depression in the elderly

Cited by 13 publications

References 30 publications

Late-life depression in private practice depressed outpatients: a 203-case study

Late-life depression in private practice depressed outpatients: a 203-case study

Chapter 7; Depression and Anxiety

Pharmacological treatment of depression in older primary care patients: the PROSPECT algorithm

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