Pharmacotherapy of Depressive Disorders in Older Patients

Depression in older patients contributes to personal suffering and family disruption and increases disability, medical morbidity, mortality, suicide risk, and healthcare utilization. However, because the majority of clinical trials of antidepressants are conducted in younger patients, there is a lack of empirical data specific to older patients. In addition, older patients also often have serious coexisting medical problems that may contribute to the depression and complicate choice of treatment; they also metabolize medications more slowly and are more sensitive to side effects than younger patients. Based on a survey of 50 experts in geriatric psychiatry, these Expert Consensus Guidelines™ address a number of key questions concerning the pharmacological treatment of depression in older adults. The guidelines cover assessment of depression in older patients, selection of acute treatment strategies and medications, dosing and duration of treatment, treatment resistance, and strategies for continuation and maintenance treatment. Guidelines are also provided concerning the treatment of depression in the presence of comorbid medical conditions and the management of depression that is associated with a medication. A guidelines also deals with combining medications in older patients, which is a particularly important area since older patients are often receiving a larger number of medications than younger patients. Also included is a "Guide for Patients and Families." that was developed with the assistance of the National Depressive and Manic-Depressive Association (NDMDA), the American Association of Geriatric Psychiatry, and the Alzheimer's Association.
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The following files are available for download:

A. Editors, experts, and contents pages from the guidelines

Adobe Acrobat format (91 KB)

B. Depression in Older Adults: A Guide for Patients and Families

Adobe Acrobat format (249 KB)

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