Treatment of Depression in the Elderly: A systematic review

Introduction: depression is a common disorder and a major public health problem in the elderly. despiteits prevalence and seriousness, depressive disorder in older people remains under-treated. the optimaltreatment of depression in later life is crucial, and requires appreciation of several age-related factors suchas comorbidity, polypharmacy, altered drug kinetics, variable treatment responses and increasedpredisposition to side effects. discussion: although sometimes difficult to diagnose because of concurrentstressors, medical illness, or dementia, depression in elderly patients responds readily to appropriatetherapy. when untreated, this disorder may result in increased morbidity and mortality or suicide.effective therapeutic options for late-life depression, as in younger patients, include psychotherapy andpharmacotherapy. because of their favorable adverse effect profiles and safety in cases of overdose, theselective serotonin reuptake inhibitors have, in most cases, replaced tricyclic antidepressants as first-linetherapy when antidepressants are indicated. the ssris considered to have the best safety profile in theelderly are citalopram, escitalopram, and sertraline. finally, electroconvulsive therapy offers a safe andeffective alternative for patients refractory to or unable to tolerate antidepressant medication.