Citation

Taylor WD. New Engl. J. Med. 2014; 371(13): 1228-1236.

Copyright

(Copyright © 2014, Massachusetts Medical Society)

DOI

10.1056/NEJMcp1402180

PMID

25251617

Abstract

Key Clinical Points Care of the Asplenic Patient Late-life depression (occurring in persons 60 years of age or older) is common and is often associated with coexisting medical illness, cognitive dysfunction, or both. Depressed older adults are at increased risk for suicide. Asplenic patients in whom fever develops should receive empirical antimicrobial therapy immediately. Screening for depression is important, but positive screening results should be followed by a thorough evaluation to assess patient safety and ensure that treatment is warranted. Either pharmacotherapy or psychotherapy may be used as first-line therapy. Currently available antidepressants show efficacy in depressed older populations, but older adults may be at increased risk for medication side effects. Selective serotonin-reuptake inhibitors (SSRIs) are considered first-line pharmacotherapy. Standardized psychotherapy techniques are also effective for depression in older adults.

Language: en