A Systematic Approach to Pharmacotherapy for Geriatric Major Depression

被引：66

作者：

Mulsant, Benoit H. ^{[1
,2
]}

Blumberger, Daniel M. ^{[2
,3
]}

Ismail, Zahinoor ^{[1
,4
]}

Rabheru, Kiran ^{[5
]}

Rapoport, Mark J. ^{[2
,6
]}

机构：

[1] Ctr Addict & Mental Hlth, Toronto, ON M61 1H4, Canada

[2] Univ Toronto, Fac Med, Dept Psychiat, Toronto, ON M5T 1R8, Canada

[3] Ctr Addict & Mental Hlth, Temerty Ctr Therapeut Brain Intervent, Toronto, ON M61 IH4, Canada

[4] Univ Calgary, Foothills Hosp, Hotchkiss Brain Inst, Calgary, AB T2N 2T9, Canada

[5] Univ Ottawa, Ottawa Hosp, Dept Psychiat, Geriatr Psychiat ECT Program, Ottawa, ON K1N 5C7, Canada

[6] Sunnybrook Hlth Sci Ctr, Toronto, ON M4C 5N6, Canada

来源：

CLINICS IN GERIATRIC MEDICINE | 2014年 / 30卷 / 03期

关键词：

Major depressive disorder; Geriatrics; Old age; Antidepressant agents; Drug therapy; Guidelines; Algorithm; Stepped care; PRIMARY-CARE PATIENTS; SEROTONIN REUPTAKE INHIBITORS; LATE-LIFE DEPRESSION; ANTIDEPRESSANT EFFICACY TRIALS; REDUCING SUICIDAL IDEATION; DOUBLE-BLIND; TRICYCLIC ANTIDEPRESSANTS; ELDERLY-PATIENTS; 2ND-GENERATION ANTIDEPRESSANTS; PHARMACOLOGICAL TREATMENT;

D O I：

10.1016/j.cger.2014.05.002

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

The broadening use of antidepressants among older Americans has not been associated with a notable decrease in the burden of geriatric depression. This article, based on a selective review of the literature, explores several explanations for this paradox. The authors propose that the effectiveness of antidepressants depends in large part on the way they are used. Evidence supports that antidepressant pharmacotherapy leads to better outcomes when guided by a treatment algorithm as opposed to attempting to individualize treatment. Several published guidelines and pharmacotherapy algorithms developed for the treatment of geriatric depression are reviewed, and an updated algorithm proposed.

引用

页码：517 / +

页数：19

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