The elderly depressed and treatment with fluvoxamine.
Depression is highly prevalent in the elderly and there are difficulties with definition and diagnosis. The signs and symptoms of depression may differ from those in younger patients since the elderly are frequently preoccupied with physical ailments and may have more agitation, insomnia and hypochondriasis. The aetiology and cause of depression and its association with psychosocial and other risk factors are discussed, with particular reference to masked depression, depressive delusional illness and 'pseudo dementia'. A range of treatments have been used in depressive patients, including psychotherapy, cognitive therapy, ECT and various drug treatments. In the elderly drugs may cause more problems than in younger patients. These can be divided into those associated with: pharmacokinetics, polypharmacy, side effects, dosage and lethality. Trials of antidepressants in the elderly are discussed and include trials with tricyclic antidepressants, monoamine oxidase inhibitors and SSRIs. Particular reference is made to a trial of fluvoxamine versus mianserin in the elderly, which demonstrated that fluvoxamine is as effective as mianserin in treating depression, and has fewer side effects.
Phanjoo
A
A
Royal Edinburgh Hospital, Jardine Clinic, Morningside Terrace, UK.
D000368:Aged; D000369:Aged, 80 and over; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D016666:Fluvoxamine / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008803:Mianserin / Q000009:adverse effects / Q000627:therapeutic use; D010556:Personality Tests; D012307:Risk Factors
D008803:Mianserin; D016666:Fluvoxamine