Late-Life Depression: Rationalizing Pharmacological Treatment Options

Gerontology ◽  
2002 ◽  
Vol 48 (6) ◽  
pp. 392-400 ◽  
Author(s):  
Stuart A. Montgomery
Keyword(s):  
Pharmacological Treatment ◽  
Treatment Options ◽  
Late Life ◽  
Late Life Depression

Neuroanatomical Abnormalities in Older Depressed Adults With Apathy: A Systematic Review

2019 ◽  
Vol 33 (5) ◽  
pp. 289-303 ◽  
Author(s):  
Monique A. Pimontel ◽  
Dora Kanellopoulos ◽  
Faith M. Gunning
Keyword(s):  
Systematic Review ◽  
Treatment Options ◽  
Late Life ◽  
Anterior Cingulate ◽  
Late Life Depression ◽  
Efficacious Treatment ◽  
Focal Brain Injury ◽  
Aging Populations ◽  
Future Treatments ◽  
Poor Outcomes

Objective: Apathy is a common phenomenon in late-life depression and is associated with poor outcomes. Apathy is often unrecognized in older depressed adults, and efficacious treatment options are lacking. This review provides a systematic review of the neuroanatomical abnormalities associated with apathy in late-life depression. In addition, the review summarizes the neuroimaging findings from studies of neurodegenerative and focal brain injury conditions that frequently present with apathy. The goal is to elucidate cerebral network abnormalities that give rise to apathy in older adults with mood disturbances and to inform future treatment targets. Method: Systematic literature review. Results: The few studies that have directly examined the neuroanatomical abnormalities of apathy in late-life depression suggest disturbances in the anterior cingulate cortex, insula, orbital and dorsal prefrontal cortex, striatum, and limbic structures (ie, amygdala, thalamus, and hippocampus). Studies examining the neuroanatomical correlates of apathy in other aging populations are consistent with the pattern observed in late-life depression. Conclusions: Apathy in late-life depression appears to be accompanied by neuroanatomical abnormalities in the salience and reward networks. These network findings are consistent with that observed in individuals presenting with apathy in other aging-related conditions. These findings may inform future treatments that target apathy.

scholarly journals Some of the CANMAT Recommendations for the Pharmacological Treatment of Late-life Depression Are Not Congruent with Available Evidence or Expert Opinion

2017 ◽  
Vol 62 (5) ◽  
pp. 351-352
Author(s):  
Daniel Blumberger ◽  
David Conn ◽  
John S. Kennedy ◽  
Benoit H. Mulsant ◽  
Bruce G. Pollock ◽  
...  
Keyword(s):  
Expert Opinion ◽  
Pharmacological Treatment ◽  
Late Life ◽  
Late Life Depression

Treatment preferences for depression in the elderly

2016 ◽  
Vol 29 (3) ◽  
pp. 389-398 ◽  
Author(s):  
Claudia Luck-Sikorski ◽  
Janine Stein ◽  
Katharina Heilmann ◽  
Wolfgang Maier ◽  
Hanna Kaduszkiewicz ◽  
...  
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Treatment Options ◽  
Treatment Success ◽  
Depression Scale ◽  
Late Life ◽  
Care Utilization ◽  
Treatment Preferences ◽  
Late Life Depression ◽  
Care Needs

ABSTRACTBackground:If patients are treated according to their personal preferences, depression treatment success is higher. It is not known which treatment options for late-life depression are preferred by patients aged 75 years and over and whether there are determinants of these preferences.Methods:The data were derived from the German “Late-life depression in primary care: needs, health care utilization, and costs (AgeMooDe)” study. Patients aged 75+ years (N = 1,230) were recruited from primary care practices. Depressive symptoms were determined using the Geriatric Depression Scale (GDS-15). Support for eight treatment options was determined.Results:Medication, psychotherapy, talking to friends and family, and exercise were the preferred treatment options. Having a GDS score ≥ 6 significantly lowered the endorsement of some treatment options. For each treatment option, the probability of choosing the indecisive category “I do not know” was significantly increased in participants with moderate depressive symptoms.Conclusions:Depressive symptoms influence the preference for certain treatment options and also increase indecision in patients. The high preference for psychotherapy suggests a much higher demand for late-life psychotherapy in the future. Healthcare systems should begin to prepare to meet this anticipated need. Future studies should include previous experience with treatment methods as a confounding variable.

scholarly journals Review of treatment for late-life depression

2013 ◽  
Vol 19 (4) ◽  
pp. 302-309 ◽  
Author(s):  
Charlotte L. Allan ◽  
Klaus P. Ebmeier
Keyword(s):  
Selective Serotonin Reuptake Inhibitors ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Late Life ◽  
Line Treatment ◽  
Late Life Depression ◽  
Nonpharmacological Treatment ◽  
Augmentation Strategies ◽  
Treatment Of Depression ◽  
Favourable Side Effect Profile

SummaryDepressive disorder in those over the age of 60 has many clinical similarities to depression in younger adults, but biological changes related to ageing may necessitate a different approach to treatment. We present an evidence-based review of treatment for late-life depression, focusing on pharmacological approaches, including monotherapy, combination and augmentation strategies. Selective serotonin reuptake inhibitors such as sertraline and citalopram are well tolerated, have the advantage of a favourable side-effect profile, and are good options for first-line treatment. Second-line treatment options include combination therapy with a second antidepressant, or treatment augmentation with an antipsychotic or lithium. We also consider evidence for nonpharmacological treatment strategies, including psychological therapy and neurostimulation. Finally, we summarise evidence for treatment of depression in patients in dementia.

Pharmacological Treatment of Late-Life Depression

2005 ◽  
Vol 38 (01) ◽  
Author(s):  
D Ignjatovic ◽  
M Ignjatovic ◽  
DJ Nutt
Keyword(s):  
Pharmacological Treatment ◽  
Late Life ◽  
Late Life Depression

scholarly journals Response to Letter Regarding CANMAT Recommendations for the Pharmacological Treatment of Late-life Depression

2017 ◽  
Vol 62 (5) ◽  
pp. 353-354
Author(s):  
Raymond W. Lam ◽  
Zahinoor Ismail ◽  
Glenda M. MacQueen ◽  
Roumen V. Milev ◽  
Sagar V. Parikh ◽  
...  
Keyword(s):  
Pharmacological Treatment ◽  
Late Life ◽  
Late Life Depression

Refining Evidence-Based Treatments for Late-Life Depression

GeroPsych ◽  
2015 ◽  
Vol 28 (2) ◽  
pp. 67-76
Author(s):  
Grace C. Niu ◽  
Patricia A. Arean
Keyword(s):  
Older Adults ◽  
Mental Illness ◽  
Brain Plasticity ◽  
Late Life ◽  
Aging Population ◽  
The United States ◽  
Future Research ◽  
Evidence Based ◽  
Late Life Depression ◽  
Evidence Based Treatments

The recent increase in the aging population, specifically in the United States, has raised concerns regarding treatment for mental illness among older adults. Late-life depression (LLD) is a complex condition that has become widespread among the aging population. Despite the availability of behavioral interventions and psychotherapies, few depressed older adults actually receive treatment. In this paper we review the research on refining treatments for LLD. We first identify evidence-based treatments (EBTs) for LLD and the problems associated with efficacy and dissemination, then review approaches to conceptualizing mental illness, specifically concepts related to brain plasticity and the Research Domain Criteria (RDoc). Finally, we introduce ENGAGE as a streamlined treatment for LLD and discuss implications for future research.

Scholarship and Politics in the Examination of Late-Life Depression

1996 ◽  
Vol 41 (5) ◽  
pp. 491-493 ◽  
Author(s):  
Antonette M. Zeiss
Keyword(s):  
Late Life ◽  
Late Life Depression
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