Depression in elderly patients.

Depression is a common reaction to the vicissitudes of life among elderly people. Aged persons are physiologically and psychologically less able to adapt, yet they are required to change their life styles because of retirement, lowered financial resources, death of family and friends, and illness. Although many mental health professionals are reluctant to treat geropsychiatric patients, the prognosis for depressed patients can be good. Drug therapy is usually the most effective, although psychotherapy and other behavioral therapies may be used adjunctively. Electroconvulsive therapy (ECT) may be indicated for severely depressed patients. The beginning dosage of medication should be lower than for younger patients, and elderly patients must be monitored carefully for side effects. Adverse reactions due to multiple drug interactions are also possible. When aged persons become severely depressed, they are at high risk of suicide; almost all suicide attempts by elderly people are successfl. Depression in later life is treatable, and the pessimism that often surrounds the prognosis for geropsychiatric patients is unwarranted.