Treatment of depressive disorders in old age

Results indicate that major depressive disorders among the aged can be effe ctively treated by administration of sertraline, fluoxetine, reboxetine, no rtriptyline, imipramine, and buproprion sustained release. When secondary o utcome measures have been utilized, sertraline has been determined to be su perior to nortriptyline and fluoxetine in improving cognitive functioning. Sertraline may have fewer side effects than nortriptyline. Sertraline, cita lopram, and mianserin are effective in reducing depressive symptoms among a ged patients with mild or moderate dementia. Imipramine, reboxetine and par oxetine have been proven in double-blind studies to reduce depressive sympt oms among dysthymic patients or patients with minor depression, and sertral ine has been proven to reduce symptoms in an open trial. The results sugges t that maintenance therapy with antidepressants in old age may be safe and effective in preventing recurrences of depression, but further studies are needed. Unfortunately, fewer studies have been conducted regarding the effe cts of psychological treatment of depression in old age. Curr Opin Psychiat ry 14:387-393. (C) 2001 Lippincott Williams & Wilkins.