title: Treatment-resistant Late-life Depression: Challenges and Perspectives.
abstract: The current Review article provides a narrative review about the neurobiological underpinnings and treatment of treatment resistant late-life depression (TRLLD). The manuscript focuses on therapeutic targets of late-life depression, which include pharmacological, psychological, biophysical and exercise treatment approaches. Therefore, we summarize available evidences on that kind of therapies for patients suffering from late-life depression. The search for evidences of therapeutic options of late-life depression were done using searching websites as "pubmed", and using the searching terms "depression", "late-life depression", "treatment", "biophysical therapy", "exercise therapy", "pharmacological therapy" and "psychological therapy". To the end, we summarize and discuss current data, providing some directions for further research. Treatment recommendations for elderly depressive patients favour a multimodal approach, containing psychological, pharmacological and secondary biophysical therapeutic options. Particularly, a combination of psychotherapy and antidepressant medication reflects the best therapeutic option. However, mostly accepted and used is the pharmacological treatment although evidence suggests that the drug therapy is not as effective as it is in younger depressive patients. Further studies employing larger samples and longer follow-up periods are necessary and may focus on comparability of study designs and involve novel approaches to establish the validity and reliability of multimodal treatment programs.
authors.forename: Christian
authors.initials: C
authors.lastname: Knöchel
authors.forename: Gilberto
authors.initials: G
authors.lastname: Alves
authors.forename: Benedikt
authors.initials: B
authors.lastname: Friedrichs
authors.forename: Barbara
authors.initials: B
authors.lastname: Schneider
authors.forename: Anna
authors.initials: A
authors.lastname: Schmidt-Rechau
authors.forename: Sofia
authors.initials: S
authors.lastname: Wenzler
authors.forename: Angelina
authors.initials: A
authors.lastname: Schneider
authors.forename: David
authors.initials: D
authors.lastname: Prvulovic
authors.forename: André F
authors.initials: AF
authors.lastname: Carvalho
authors.affiliation: Laboratory for Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy; Heinrich- Hoffmann-Str. 10, Goethe-University, 60528 Frankfurt/Main.
authors.forename: Viola
authors.initials: V
authors.lastname: Oertel-Knöchel
mesh_terms: D000818:Animals; D061218:Depressive Disorder, Treatment-Resistant / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D019468:Disease Management; D006801:Humans