Treatment

Treatment requires the following to be bourne in mind:

• remember interactions in multiply medicated patients
• there may be increased memory loss in some patients on antidepressants
• patients have less functional reserve, thus might experience side effects sooner than younger patients
• behavioural methods can be effective if the indications exist

NICE have stated that (1):

• for older adults with depression, antidepressant treatment should be given at an age-appropriate dose for a minimum of 6 weeks before treatment is considered to be ineffective. If there has been a partial response within this period, treatment should be continued for a further 6 weeks
• SSRIs are, in general, the antidepressant treatment of first choice in management of depression
• when prescribing antidepressants - in particular tricyclics - for older adults with depression, careful monitoring for side effects should be undertaken
• note that there is an increased frequency of drug interactions when prescribing an antidepressant to older adults who are taking other medications

For more detailed guidance then consult full guideline (1)

Reference:

1. NICE (December 2004). Management of depression in primary and secondary care.