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General Medicine

Depression, Geriatric

Benjamin James Cottrell, D.O. and Rose Katherine Appel, DO Reviewed 04/2024
 


BASICS

DESCRIPTION

A primary mood disorder characterized by a depressed mood and/or a markedly decreased interest or pleasure in normally enjoyable activities most of the day, almost every day for at l...

DIAGNOSIS

Refer to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria 

HISTORY

  • Depressed mood most of the day, nearly every day, and/or loss of interest/pleasure in life...

TREATMENT

Although 50% reduction in symptoms alone is considered clinically meaningful; the goal is to treat the patient to the point of remission (i.e., essentially the absence of depressive symptoms...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Due to the delay of benefit following the initiation of antidepressant therapy, it is necessary to ensure open communication with the patient to prevent premature...

REFERENCES

1
Taylor  WD. Clinical practice. Depression in the elderly. N Engl J Med.  2014;371(13):1228–1236. [View Abstract on OvidMedline]
2
...

SEE ALSO

Algorithms: Depressed Mood Associated with Medical Illness; Depressive Episode, Major 

CODES

ICD10

  • F32.9 Major depressive disorder, single episode, unspecified

  • F03 Unspecified dementia

  • F43.21 Adjustment disorder with depressed mood

  • F34.1 Dysthymic disorder

  • Z60.0 Problems of adjustment to lif...

CLINICAL PEARLS

  • Late-life depression (LLD) is not a normal part of aging.

  • Depression in the elderly may be difficult to diagnose due to medical and cognitive comorbidities.

  • Depression may present primar...

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Antidepressant drugs and the biochemical life cycles of norepinephrine and serotonin. MAO inhibitors, tricyclics, and SSRIs are used as antidepressants. MAO inhibitors enhance the actions of NE and 5-HT by preventing their enzymatic destruction. Tricyclics enhance NE and 5-HT action by blocking uptake. SSRIs act the same way but are selective for serotonin.

 

Antidepressant drugs and the biochemical life cycles of norepinephrine and serotonin. MAO inhibitors, tricyclics, and SSRIs are used as ant...

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