Skip to main content

Depression

  • Chapter
  • First Online:
Drug Therapy for the Elderly

Abstract

Depression in older people often presents with atypical symptoms. In the elderly, depression is frequently associated with physical and cognitive impairment. Compared with younger patients, older patients experiencing a depressive episode often show predominantly somatic symptoms. They frequently mislead physicians to concentrate initially on patients’ organic symptoms in particular if the patient has no history of psychiatric disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Alexopoulos GS (2005) Depression in the elderly. Lancet 365:1961–1970

    Article  PubMed  Google Scholar 

  • Alexopoulos GS, Katz IR, Reynolds CF 3rd, Carpenter D, Docherty JP (2001) The expert consensus guideline series. Pharmacotherapy of depressive disorders in older patients. Postgrad Med Spec No Pharmacotherapy :1–86

    Google Scholar 

  • Alexopoulos GS, Borson S, Cuthbert BN (2002) Assessment of late life depression. Biol Psychiatry 52:164–174

    Article  PubMed  Google Scholar 

  • Alvarez PA, Pahissa J (2010) QT alterations in psychopharmacology: proven candidates and suspects. Curr Drug Saf 5:97–104

    Article  PubMed  CAS  Google Scholar 

  • American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  • Bauer M, Bschor T, Pfennig A et al (2007) World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders in primary care. World J Biol Psychiatry 8:67–104

    Article  PubMed  Google Scholar 

  • Bauer M, El-Khalili N, Datto C, Szamosi J, Eriksson H (2010) A pooled analysis of two randomised, placebo-controlled studies of extended release quetiapine fumarate adjunctive to antidepressant therapy in patients with major depressive disorder. J Affect Disord 127:19–30

    Article  PubMed  CAS  Google Scholar 

  • Bergman J, Miodownik C, Palatnik A, Lerner V (2011) Efficacy of bupropion XR in treatment-resistant elderly patients: a case series study. Clin Neuropharmacol 34:17–20

    Article  PubMed  CAS  Google Scholar 

  • Bondareff W, Alpert M, Friedhoff AJ et al (2000) Comparison of sertraline and nortriptyline in the treatment of major depressive disorder in late life. Am J Psychiatry 157:729–736

    Article  PubMed  CAS  Google Scholar 

  • Cipriani A, Furukawa TA, Salanti G et al (2009) Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet 373:746–758

    Article  PubMed  CAS  Google Scholar 

  • Coupland C, Dhiman P, Morriss R, Arthur A, Barton G, Hippisley-Cox J (2011) Antidepressant use and risk of adverse outcomes in older people: population based cohort study. BMJ 343:d4551. doi:10.1136/bmj.d4551

    Article  PubMed  Google Scholar 

  • Eyding D, Lelgemann M, Grouven U et al (2010) Reboxetine for acute treatment of major depression: systematic review and meta-analysis of published and unpublished placebo and selective serotonin reuptake inhibitor controlled trials. BMJ 341:c4737

    Article  PubMed  Google Scholar 

  • Goodman WK (2011) Electroconvulsive therapy in the spotlight. N Engl J Med 364:1785–1787

    Article  PubMed  CAS  Google Scholar 

  • Gribbin J, Hubbard R, Gladman J, Smith C, Lewis S (2011) Serotonin-norepinephrine reuptake inhibitor antidepressants and the risk of falls in older people: case–control and case-series analysis of a large UK primary care database. Drugs Aging 28:895–902

    Article  PubMed  CAS  Google Scholar 

  • Hausner L, Damian M, Sartorius A, Frölich L (2011) Efficacy and cognitive side effects of electroconvulsive therapy (ECT) in depressed elderly inpatients with coexisting mild cognitive impairment or dementia. J Clin Psychiatry 72:91–97

    Article  PubMed  Google Scholar 

  • Hawton K, van Heeringen K (2009) Suicide. Lancet 373:1372–1381

    Article  PubMed  Google Scholar 

  • Heok KE, Ho R (2008) The many faces of geriatric depression. Curr Opin Psychiatry 21:540–545

    Article  PubMed  Google Scholar 

  • Howland RH (2011) A benefit-risk assessment of agomelatine in the treatment of major depression. Drug Saf 34:709–731

    Article  PubMed  CAS  Google Scholar 

  • Jalenques I, Legrand G, Vaille-Perret E, Tourtauchaux R, Galland F (2010) EfficacitĂ© et tolĂ©rance de la stimulation magnĂ©tique transcrânienne (SMTr) dans le traitement des dĂ©pressions chez le sujet âgĂ©: revue de la littĂ©rature. EncĂ©phale 36(Suppl 2):D105–D118

    Article  PubMed  Google Scholar 

  • Kirsch I, Deacon BJ, Huedo-Medina TB et al (2008) Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med 5:e45

    Article  PubMed  Google Scholar 

  • Kok RM, Heeren TJ, Nolen WA (2011) Continuing treatment of depression in the elderly: a systematic review and meta-analysis of double-blinded randomized controlled trials with antidepressants. Am J Geriatr Psychiatry 19:249–255

    Article  PubMed  Google Scholar 

  • Meeks TW, Vahia IV, Lavretsky H, Kulkarni G, Jeste DV (2011) A tune in “a minor” can “b major”: a review of epidemiology, illness course, and public health implications of subthreshold depression in older adults. J Affect Disord 129:126–142

    Article  PubMed  Google Scholar 

  • Mottram P, Wilson K, Strobl J (2006) Antidepressants for the elderly. Cochrane Database Syst Rev 1:CD003491

    PubMed  Google Scholar 

  • Pinquart M, Duberstein PR, Lyness JM (2006) Treatments for later-life depressive conditions: a meta-analytic comparison of pharmacotherapy and psychotherapy. Am J Psychiatry 163:1493–1501

    Article  PubMed  Google Scholar 

  • Pinquart M, Duberstein PR, Lyness JM (2007) Effects of psychotherapy and other behavioral interventions on clinically depressed older adults: a meta-analysis. Aging Ment Health 11:645–657

    Article  PubMed  CAS  Google Scholar 

  • Raskin J, Wiltse CG, Siegal A, Sheikh J, Xu J, Dinkel JJ, Rotz BT, Mohs RC (2007) Efficacy of duloxetine on cognition, depression, and pain in elderly patients with major depressive disorder: an 8-week, double-blind, placebo-controlled trial. Am J Psychiatry 164:900–909

    Article  PubMed  Google Scholar 

  • Rodda J, Walker Z, Carter J (2011) Depression in older adults. BMJ 343:d5219

    Article  PubMed  Google Scholar 

  • Szegedi A, Jansen WT, van Willigenburg AP et al (2009) Early improvement in the first 2 weeks as a predictor of treatment outcome in patients with major depressive disorder: a meta-analysis including 6,562 patients. J Clin Psychiatry 70:344–353

    Article  PubMed  Google Scholar 

  • Tess AV, Smetana GW (2009) Medical evaluation of patients undergoing electroconvulsive therapy. N Engl J Med 360:1437–1444

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stefan Schwarz .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Wien

About this chapter

Cite this chapter

Schwarz, S., Frölich, L. (2013). Depression. In: Wehling, M. (eds) Drug Therapy for the Elderly. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0912-0_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-0912-0_16

  • Published:

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-0911-3

  • Online ISBN: 978-3-7091-0912-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics