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Treatment Options for Elderly Depression

Individuals who are 65 or older and diagnosed with clinical or major depression can be treated with a good outcome. Statistically 80% of those diagnosed with clinical depression have effectively been treated with a combination of medication and psychotherapy and/or electro convulsive therapy (ECT) successfully at the age of 65 or older.

Medications used in the elderly who suffer from depression generally fall into one of four categories of antidepressant medications. These categories are tricyclics, monoamine oxidase inhibitors (MAOIs), selective serotonin re-uptake inhibitors (SSRIs), or norepinephrine & serotonin reuptake inhibitors (NSRIs). No matter the age of the individual with depression in order for the medication to be effective it must be taken at the correct dosage (quantity and timing) with no missed or skipped dosages. The pharmacist or doctor in charge of the individual should advise accidental dosages as to how to handle the next dose. The patient placed on antidepressant medication therapy should never take himself or herself off the medication without the supervision of a doctor. The elderly individual is especially at risk for failure to take medication properly and should have some kind of backup system (person who checks up on them) or a device that will remind them to take their medication. Statistically as much as 70% of those who are elderly and diagnosed with depression will fail to take their medications properly.

Medication in this category (antidepressants) does usually have side effects when taking them. The doctor prescribing the treatment should advise the patient of the side effects that may be experienced to prepare the elderly patient of the possibility and what to do when it occurs. This is a major reason for not taking medication properly. Side effects when experienced can be handled by the doctor prescribing the medication. The patient should immediately notify the doctor's office so that they can be given instructions as to what to do. The patient should be initially instructed not to discontinue the medication unless instructed to do so. When side effects are a problem for the patient, the doctor can adjust the dosage or change the medication to another antidepressant. There may also be the possibility of splitting the dosage and taking half the required dosage in the morning and half at bedtime to lessen certain side effects.

Electro convulsive therapy (ECT) has also been shown to be an effective treatment in combination with medication therapy or psychotherapy in any combination of the 3 types. ECT can be used safely and with efficacy when administered by medical professionals. There is too much misinformation circulating about ECT. This misinformation is to partly to blame for this therapy being underused, unavailable or simply ignored.

Psychosocial treatment is used widely in all age groups to treat depression but is especially important when treating an elderly individual who has depression. Psychosocial therapy allow the individual to learn new coping skills for dealing with life crises, or to develop new social support systems that will benefit their ability to overcome the depression that has stymied their healthy well-being. An understandably large number of elderly live alone as a result of divorce, spousal death, adult children moving away etc. and this puts them at risk for not having an adequate support system in place for when illnesses befall them such as depression. Psychosocial treatment gives elderly patients the skills needed to grow their support system and to enable them to ask for help when it is needed instead of remaining in isolation and a state of suffering.