Citation

Newman BM. Curr. Geriatr. Rep. 2016; 5(4): 241-247.

Copyright

(Copyright © 2016, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s13670-016-0186-5

PMID

unavailable

Abstract

Depression is a common illness in the geriatric primary care population. Risk factors including serious medical illness and functional disability, as well as neurodegeneration and cardiovascular risk factors, can make treatment particularly difficult in late-life depression. There is a paucity of well-validated evidence to guide the geriatric clinician's diagnosis and management of treatment-resistant late-life depression (TRLLD). In this article, I provide clinical recommendations for the evaluation and diagnosis of late-life depression appropriate for the geriatric primary care provider. With an accurate diagnosis, the geriatric physician can better construct a treatment plan. I will review evidence-based treatment approaches for TRLLD including antidepressant medications, augmentation strategies, psychotherapy options, and neuromodulation techniques. © 2016, Springer Science+Business Media New York.

Language: en

Keywords

human; age; Review; psychotherapy; lithium; amfebutamone; citalopram; fluoxetine; mirtazapine; monoamine oxidase inhibitor; nortriptyline; serotonin uptake inhibitor; sertraline; tricyclic antidepressant agent; venlafaxine; priority journal; cognitive therapy; electroconvulsive therapy; tranylcypromine; Elderly suicide; phenelzine; Late-life depression; aripiprazole; mood stabilizer; Mini Mental State Examination; medical history; interpersonal therapy; serotonin noradrenalin reuptake inhibitor; Geriatric Depression Scale; randomized controlled trial (topic); neuromodulation; Electroconvulsive therapy (ECT); meta analysis (topic); treatment resistant depression; Patient Health Questionnaire 9; cognitive behavioral therapy; Deep brain stimulation (DBS); Magnetic seizure treatment (MST); Repetitive transcranial magnetic stimulation (rTMS); Treatment-resistant late-life depression; Vagal nerve stimulation (VNS)