Late-life depression pharmacotherapy

Key Points

In the research trials examined in this review, paroxetine did not cause anticholinergic problems, as we’d expect per longstanding clinical concern. But this does not exonerate it, and there are alternatives.
Citalopram, and to a lesser extent escitalopram, carry the QT prolongation concern. That leaves sertraline as one of the preferred options among SRIs, which are generally less problematic than SNRIs.
Quetiapine has a demonstrated benefit in late-life depression and also confers a benefit to sleep.

Text version

Next, let’s look at a study of the treatment of depression in late life.

Is there any difference between how we should approach treatment of depression with medications in people over 60? This is not a trivial issue, of course, because we know that depression worsens the course of things like ischemic heart disease. It’s associated with worse diabetic control, and it’s associated with an increased risk of Alzheimer’s. So, we ought to be careful about how we go about treating depression in the elderly. We want good results, and yet we also know that these folks are more susceptible to potential side effects and risks of our medications. Does that change our choice of antidepressants in this age group?

Let’s look at a new review from John Beyer and Kim Johnson published in the *Current* *Psychiatric Reports* from 2018 in their article, Advances in Pharmacotherapy for Late-Life Depression. This

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04. Late-life depression pharmacotherapy

James Phelps, M.D.

Key Points

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Text version

James Phelps, M.D.

Key Points

Downloads for Offline Access

Text version

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