Pharmacotherapy of major depressive disorder in older adults: from an evidence-informed stepwise algorithm to precision medicine - PubMed
a day ago
- #pharmacotherapy
- #precision medicine
- #late-life depression
- Pharmacotherapy for late-life depression (LLD) is complex due to older adults' multimorbidity, frailty, and polypharmacy.
- A stepwise algorithm is proposed for LLD treatment, starting with SSRIs, then switching to SNRIs if no response, followed by augmentation with aripiprazole.
- For patients not responding to traditional pharmacotherapy, options include transcranial magnetic stimulation, ketamine, or electroconvulsive therapy.
- Psychotherapy can be combined with antidepressants at any treatment stage.
- Precision medicine approaches are discussed: a 'lock and key' method requiring biotyping and a 'simple vs. complex depression' approach targeting specific pathophysiology.
- Future research aims to improve outcomes for older adults with depression through these complementary approaches.