gms | German Medical Science

Depression is the commonest and the most reversible mental disease in old age and is associated with physical illness, disability, life events and social isolation. Depression in old age carries an highly increased risk of suicide and also of natural mortality. Despite a favourable response to treatment, it remains largely undetected and untreated. Current clinical practice is to prescribe the same antidepressants irrespective of age and eventually use a lower dose in elderly patients to adjust for a slower rate of metabolism compared to the younger patient population and polypharmacy. The most commonly used drugs are currently antidepressants targeting the monoaminergic system. Other drugs are agomelatine targeting both the melatonergic and serotonergic systems and monoamine oxidase inhibitors. Results from clinical trials suggest that there is not a marked difference in efficacy and safety profiles of current marketed classes of antidepressant drugs. The talk summarizes current knowledge of the effects of antidepressant drugs in elderly patients on depression-related symptoms and cognitive performances.