Original Articles
Considerations in the Treatment of Geriatric Depression: Overview of Pharmacotherapeutic and Psychotherapeutic Treatment Interventions

Research in Gerontological Nursing  Vol. 3 No. 3 July 2010

By Carlos H. Rojas-Fernandez, PharmD; Lisa J. Miller, PharmD, BCPP, CGP; Cheryl A. Sadowski, BSc (Pharm), PharmD

ABSTRACT

Geriatric (or late-life) depression is common in older adults, with an incidence that increases dramatically after age 70 to 85, as well as among those admitted to hospitals and those who reside in nursing homes. In this population, depression promotes disability and is associated with worsened outcomes of comorbid chronic medical diseases. Geriatric depression is often undetected or undertreated in primary care settings for various reasons, including the (incorrect) belief that depression is a normal part of aging. Current research suggests that while antidepressant agent use in older adults is improving in quality, room for improvement exists. Improving the pharmacotherapy of depression in older adults requires knowledge and understanding of many clinical factors. The purpose of this review is to discuss salient issues in geriatric depression, with a focus on pharmacotherapeutic and psychotherapeutic interventions.

ABOUT THE AUTHORS

Dr. Rojas-Fernandez is Schlegel Research Chair in Geriatric Pharmacotherapy and Assistant Professor, School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada; Dr. Miller is Clinical Pharmacy Specialist, Psychiatry, Michael E. DeBakey VA Medical Center, Houston, Texas; and Dr. Sadowski is Associate Professor, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada. At the time this manuscript was written, Dr. Rojas-Fernandez was Senior Medical Science Liaison, Otsuka America Pharmaceutical, Inc., Neuroscience Medical Affairs, Gaithersburg, Maryland.

The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support. Dr. Rojas-Fernandez was an employee of Otsuka America Pharmaceutical, Inc.; however, he co-wrote this article on his personal time. This article represents the opinions and views of the authors and not of Otsuka America Pharmaceutical, Inc., in any aspect.

Address correspondence to Carlos H. Rojas-Fernandez, PharmD, Schlegel Research Chair in Geriatric Pharmacotherapy and Assistant Professor, School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada N2L 3G1; e-mail: carlos.rojas-fernandez@uwaterloo.ca

Received: October 20, 2009; Accepted: April 13, 2010; Posted: June 30, 2010

doi:10.3928/19404921-20100526-01