Depression – elderly : Treatment

Treatment

Sometimes relieving loneliness through group outings, volunteer work, or having regular visitors can help with depression.

Treating the medical conditions that cause depression, or stopping certain medications can relieve the symptoms of depression.

Talking through problems (psychotherapy) with a psychologist, psychiatrist, or other therapist is also an effective treatment. In cases of moderate to severe depression, people may get the best results by combining psychotherapy with antidepressant medications.

Short-term (about 12 weeks) group-based physical exercise programs involving walking or other forms of aerobic exercise can reduce depression in older adults.

Antidepressant drug therapy has been shown to increase the quality of life in depressed elderly people. These medications are carefully monitored for side effects. Doctors usually prescribe lower doses of antidepressants for older people, and increase the dose more slowly than in younger adults.

These medications include:

  • Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro) are used as first-line treatments.
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor) and Duloxetine (Cymbalta), as well as mirtazapine (Remeron) may also be tried.
  • Tricyclic antidepressants are not used as often because of side effects, particularly for the heart.

Neuroleptic medications can help treat agitation in some people. Electroconvulsive therapy (ECT) can be used in people who are severely depressed if other treatments don’t work.

Prognosis (Expectations)

Depression can respond to medical treatment. If it is not detected, depression can lead to complications. The outcome is usually worse for people who have limited access to social services, or to family or friends who can help them stay interested in activities.

Complications

Depression can be complicated by Alzheimer’s disease or other forms of dementia. It also can complicate other medical conditions in the elderly.

Suicide in the elderly is one of the leading causes of death related to injury. Men account for most of these suicides, and divorced or widowed men are at the highest risk. Families should pay special attention to elderly male relatives who are alone. In addition to finding psychiatric help for them, family members should remove anything from their homes (such as knives) that they could use to harm themselves.

Calling Your Health Care Provider

Call your health care provider if you feel worthless or hopeless, or if you cry often. Also call if you are having trouble coping with stresses in your life and want to be referred for counseling.

Go to the nearest emergency room or call your local emergency number (such as 911) if you are thinking about suicide (taking your own life).

If you are caring for an aging family member and think they may have depression, contact their health care provider. Often, older patients will not admit to the signs and symptoms of depression out of pride.


Review Date : 8/22/2008
Reviewed By : Timothy A. Rogge, MD, private practice in Psychiatry, Kirkland, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsements of those other sites. © 1997- 2010 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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