Aktuelle Therapie der Depression im Alter

摘要

Although the prevalence of depression in old age is very high, depression is often undiagnosed or pushed aside as being "understandable" due to the many losses that old people experienced. Depressive illness is a serious condition and – if untreated – associated with excess disability, medical morbidity, mortality and suicide. Elderly patients are at chronic risk of undertreatment for depression because of low expectations regarding recovery and fears about aggressive pharmacotherapy. It is important to recognise depression in old age and to make a full assessment since, with adequate treatment, patients can make a full recovery. Pharmacotherapy is the mainstay of treatment. SSRIs have replaced TCAs and are first-line therapy. But other new antidepressants such as SNRIs and NASSAs provided clinicians with more tolerable alternatives to tricyclics and monoamine oxidase inhibitors. Whichever drug is chosen, the patient should be given an adequate therapeutic dose. Adjunctive treatment with psychotherapy or psychosocial interventions is also effective in elderly patients.