Clinical Section

Late-Life Depression: Rationalizing Pharmacological Treatment Options
Stuart A. Montgomery

Imperial College School of Medicine, London, UK

Address of Corresponding Author

Gerontology 2002;48:392-400 (DOI: 10.1159/000065502)

  Key Words

• Depression, late-life
• Antidepressants, safety
• Antidepressants, efficacy
• Antidepressants, pharmacokinetics

  Abstract

Background: Depressive symptoms in late life are a major concern as they increase disability and aggravate existing medical conditions. Depression is underrecognised and undertreated in the elderly, be it due to somatic symptoms, comorbid physical illness or anxiety, or because it is accepted as a normal feature of ageing. There is little doubt that effective and well-tolerated antidepressant therapy is required. Objective: This paper reviews the antidepressant treatment options for late-life depression (selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, mixed noradrenergic and serotonergic agents), in terms of their efficacy, safety and pharmacokinetics in elderly patients. Results: In addition to proven efficacy, selection of an antidepressant agent for late-life depression must be based on an understanding of safety and pharmacokinetic issues associated with each agent. Comorbid conditions and lifestyle characteristics of the elderly that are different to those encountered in the younger adult population should also be considered. Conclusion: To date, published clinical evidence in the elderly suggests that the first-choice agents for treating late-life depression are the SSRIs.

Copyright © 2002 S. Karger AG, Basel

  Author Contacts

Stuart A. Montgomery, MD
PO Box 8751
London W13 8WH (UK)
Fax +44 208 85667986
E-Mail stuart@montgomery.demon.co.uk

  Article Information

Received: Received: October 18, 2001
Accepted: November 30, 2001
Number of Figures : 0, Number of Tables : 2, Number of References : 112