Therapeutic considerations in treating depression in the elderly.

The elderly depressed patient has a clinical picture unlike that of the younger individual. The pharmacokinetic profile, for example, changes in the normal aging process, which must be considered in choosing the proper antidepressant--and dosage--for an older person. Depressive illnesses are described in this review, with the focus on symptoms, prevalence, diagnosis, and treatment modalities. Cited are results of studies comparing tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs). Equivalent efficacy of the two classes of drugs was not unexpected. The higher degree of tolerability with SSRIs, however, should be of special interest to the clinician treating the elderly.