Pharmacological Treatment of Late-Life Depression

D. Ignjatovic; M. Ignjatovic; D. J. Nutt

doi:10.1055/s-2005-862659

Pharmacopsychiatry, Table of Contents

Pharmacological Treatment of Late-Life Depression

D Ignjatovic ¹, M Ignjatovic ², DJ Nutt ³

¹Mentee of CINP Mentor-Mentee Program, Non Governmental Psychiatric out Department, Banská Bystrica, Slovak Republic
²Non Governmental Psychiatric out Department, Banská Bystrica, Slovak Republic
³Mentee Program, Professor of Psychopharmacology, Head of Department of Community Based Medicine, University of Bristol, Psychopharmacology Unit, Bristol

Abstract

Late-life depression is common serious health problem with high pharmacotherapy response rate (Solai 2000). Approximately 60% of depressive patients in elderly suffer from somatic disease and beside the antidepressants they are treated with other medication (Gottfries 1996). Pharmaceuticals such as antihypertensive drugs/metyldopa, propranolol/, antiparkinsonics/levodopa, karbidopa, amantadine/, hormones/estrogen, progesteron/, corticoids, antituberculotics and anticancer drugs/vincristine, vinblastine/are very frequently used in elderly and could provoke depressive disorder (Hales 1991, Gottfries 1996, Karlsson 1996, Cooke 2001). Our study was designed as retrospective assessment of 58 elderly patients in the treatment of depression. Patients fulfilled inclusion criteria for depression with or without dementia. 42 patients were treated with citalopram 20mg daily, 7patients were treated with sertraline 50mg daily and 3 patients with paroxetine 20mg daily, 4 patients used fluvoxamin 50mg/day, 1 patient used fluoxetin 20mg/day,1 patient used trazodon 75mg/day, 1 patient used maprotilin 75mg/day and 1 venlafaxin 50mg/day. Incidence of adverse events during antidepressive therapy was monitored. Citalopram was the most frequently used and best-tolerated antidepressant. 28 patients were treated with anxiolytics-21 used clonazepam 0.5mg daily for sleeping disorders. Neuroleptics were used in 18 patients with behavioral and psychological symptoms of dementia (BPSD). Each of 58 patients suffered from at least one co-morbid chronic somatic disease.

The aim of the study: Overview of antidepressive therapy in elderly during one month period at two private psychiatric out-patient units.

Overview of other psychopharmacotherapy and the undesirable effects of antidepressants.

Conclusion: Depression is very common in elderly people and some people with Alzheimer's disease are suffering from depression too. Early diagnostic and adequate treatment of depression in elderly is very important. In our retrospective assessment we studied 58 depressive patients with or without dementia and the most frequent and the best tolerated antidepressant was citalopram.

References: Alexopoulos GS: The Treatment of Depressed Demented Patients, 1996, J Clin Psychiatry 57,/suppl.14:14–20; Baumann P: Care of depression in the elderly: comparative pharmacokinetics of SSRIs, Int Clin Psychopharmacology, 13 Suppl. 5: S35-S43, 1998; Briley M, Montgomery S: Antidepressant Therapy at the dawn of the third Millennium, 349:69–87, 333–349, 1998; Hales RE, Yudovsky SC, Talbott JA: Textbook of Psychiatry, Second Edition, The American Psychiatric Press, 562:313–353, 99–100.