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When treating depression in older adults, the clinician should ensure that the patient has received an adequate dose of medication for an adequate amount of time before considering a medication change. The patient’s co-occurring medical and psychiatric comorbidities should be considered. A treatment algorithm and a measurement-based approach should be followed, while attending to patient- and age-specific conditions that may interfere with treatment response. Psychotherapeutic approaches should always be included, especially one of several time-limited and structured therapies that have shown efficacy in late-life depression. When prescribing antidepressant medications, the best approach is “Start low, go slow, but go all the way.” Augmentation should be used for partial response and the medication should be switched for nonresponse. Clinicians should always engage caregivers and should implement a treatment team model. |
