MANAGEMENT OF TREATMENT RESISTANCE IN THE DEPRESSED GERIATRIC-PATIENT

The identification and treatment of depression in elderly patients oft en is problematic, particularly when a medical problem or physical dys function is an additional consideration. This article reviews the epid emiology of geriatric depression, addresses definitions of treatment r esistance in this population, and discusses specific clinical problems that render adequate treatment difficult. The existing literature tha t addresses the utility of specific somatic therapies also is discusse d. the article concludes with a discussion of the frail elderly, and r ecommendations for treatment planing are made.