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Antidepressants in Elderly Patients with Major and Minor Depression: A Review of Clinical Effectiveness and Guidelines

Published on: August 17, 2015
Project Number: RC0688-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness and safety of antidepressants in elderly patients with major and minor depression in any setting (home, long-term care, or hospital)?
  2. What are the evidence-based guidelines associated with the use of antidepressants in elderly patients with major and minor depression in any setting (home, long-term care, or hospital)?

Key Message

Four systematic reviews, two pooled analyses, two randomized controlled trials and one cohort study provided evidence of the efficacy and safety of antidepressants in older adults. A number of antidepressants appear to be effective in those aged 65 and older, relative to placebo, in achieving remission of symptoms and treatment response, but there is limited evidence of comparative efficacy between antidepressants. Potential concerns regarding safety were identified across multiple classes of antidepressant, but were based upon cohort studies, suggesting more rigorous, long-term studies of safety in this population are needed. Four evidence-based guidelines included recommendations that antidepressant dosages be adjusted in elderly patients to improve tolerability and to consider the impact of comorbidities.

Tags

aged, amitriptyline, antidepressants, antidepressive agents, bupropion, depression, depressive disorder, elderly, geriatrics, gerontology, mental health, phenelzine, trazodone, dépression, Antidepressant, Behavioural, Depressed, Major, Seniors