Drug therapy for depression in the elderly

Abstract

Depression is common in the geriatric population, but recovery rates are gratifying. Safe treatment requires attention to the effects of aging on pharmacokinetics and close monitoring. Antidepressants are the drugs most commonly used; to the standard tricyclic drugs have now been added a tetracyclic and a triazolopyridine. Monoamine oxidase inhibitors and lithium are second-choice options; a benzodiazepine is not generally required. Dosages should be lower than conventionally prescribed. Side effects of antidepressant drugs are common, the most important being slowing of cardiac conduction times and the most common being anticholinergic manifestations, such as dry mouth and tachycardia. Some of the more recently introduced antidepressants may have more advantageous side-effect profiles than the older agents.