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Review
. 2014 Aug;30(3):517-34.
doi: 10.1016/j.cger.2014.05.002. Epub 2014 Jun 14.

A systematic approach to pharmacotherapy for geriatric major depression

Benoit H Mulsant  1 , Daniel M Blumberger  2 , Zahinoor Ismail  3 , Kiran Rabheru  4 , Mark J Rapoport  5
Affiliations
Review

A systematic approach to pharmacotherapy for geriatric major depression

Benoit H Mulsant et al. Clin Geriatr Med. 2014 Aug.

Abstract

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.

Keywords: Algorithm; Antidepressant agents; Drug therapy; Geriatrics; Guidelines; Major depressive disorder; Old age; Stepped care.

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Figures

Figure 1A
Figure 1A
Response Rates in Nine Published Randomized Placebo-Controlled Trials of Newer Antidepressants
Figure 1B
Figure 1B
Remission Rates in Nine Published Randomized Placebo-Controlled Trials of Newer Antidepressants
Figure 1C
Figure 1C
Discontinuation Rates Attributed to Adverse Effects in Nine Published Randomized Placebo-Controlled Trials of Newer Antidepressants
Figure 1D
Figure 1D
Overall Discontinuation Rates Published in Nine Published Randomized Placebo-Controlled Trials of Newer Antidepressants * significant difference between antidepressant and placebo
See this image and copyright information in PMC

References

    1. Olfson M, Marcus SC. National patterns in antidepressant medication treatment. Arch Gen Psychiatry. 2009;66(8):848–56. - PubMed
    1. Pratt LA, Brody DJ, Gu Q. Antidepressant Use in Persons Aged 12 and Over: United States, 2005–2008. NCHS Data Brief; No. 76. 2011 Oct; http://www.cdc.gov/nchs/data/databriefs/db76.pdf Accessed on April 12, 2014. - PubMed
    1. Mojtabai R, Olfson M. National trends in long-term use of antidepressant medications: results from the US National Health and Nutrition Examination Survey. J. Clin Psychiatry. 2014;75(2):169–77. - PubMed
    1. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS. National Comorbidity Survey Replication. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;289(23):3095–105. - PubMed
    1. Kessler RC, Birnbaum H, Bromet E, Hwang I, Sampson N, Shahly V. Age differences in major depression: results from the National Comorbidity Survey Replication (NCS-R). Psychol Med. 2010;40(2):225–37. - PMC - PubMed

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