[Depression in the elderly. Rigorous evaluation of drug treatment].
METHODS
There is a general consensus on two points: it takes about 2 months for symptoms to resolve; treatment for 4 to 6 months thereafter reduces the risk of relapse. The same dose should be used for both periods. Likewise for prophylaxis against recurrent depression (long-term treatment for several years).
There are three major risks in elderly patients with depression: relapse, chronic depression, suicide. Improved quality care for depressive patients is a major public health issue. It is essential to recognize affected patients who require regular care in order to reduce the risk of non-observance (30-70% of the cases).
Differentiate minor depression from major depression. Wait 7 days before evaluating drug efficacy. Be aware of the risk of desinhibition. See the patient and his/her relations often. Take steps to prevent suicide using appropriate drugs. Favor psychological counseling. Use single-drug regimens preferentially. Prescribe for a sufficiently long period (life?).
Barbier
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Secteur 84.G.02, Centre Hospitalier de Montfavet, 2, avenue de la Pinède, BP 92, F 84128 Montfavet.
D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004334:Drug Administration Schedule; D015577:Geriatric Assessment; D005852:Geriatric Psychiatry; D006801:Humans; D011634:Public Health; D012008:Recurrence; D012307:Risk Factors; D013405:Suicide
D000928:Antidepressive Agents