Antidepressants for Elderly People

1. Front Matter

   Pages i-x

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2. The Nature and Presentation of Depression

   1. Front Matter

      Pages 1-1

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   2. Presentation and assessment of depression in old age

      • Vimal K. Sharma, John R. M. Copeland

      Pages 3-11

   3. Identification of depression in geriatric medical patients

      • Anthony J. Bayer, M. S. John Pathy

      Pages 13-25

   4. The epidemiology and natural history of depression in old age

      • Cornelius L. E. Katona

      Pages 27-42

   5. Neuroendocrine abnormalities in depression and the influence of drugs

      • Ian McKeith

      Pages 43-63

3. Lithium Salts

   1. Front Matter

      Pages 65-65

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   2. Metabolic and endocrine effects of lithium

      • John H. Lazarus

      Pages 67-83

   3. Clinical pharmacology of lithium salts

      • Karabi Ghose

      Pages 85-102

   4. Lithium in the prophylaxis of depressive illness in late life

      • Karabi Ghose, Alec Coppen

      Pages 103-114

4. Tricyclic and Related Antidepressants

   1. Front Matter

      Pages 115-115

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   2. Pharmacokinetics of tricyclic and related antidepressants

      • Peter Crome, Sheila Dawling

      Pages 117-136

   3. Which antidepressant?

      • Malcolm Peet

      Pages 137-162

   4. Cardiovascular effects of tricyclic antidepressants in elderly people

      • Jila Dana-Haeri, Steven J. Warrington

      Pages 163-179

   5. Side-effects of tricyclic and related antidepressants

      • Karabi Ghose

      Pages 181-198

5. Monoamine Oxidase Inhibitor Antidepressants

   1. Front Matter

      Pages 199-199

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   2. Efficacy and problems of MAO inhibitor antidepressants

      • Diana Cody, Cosmo Hallstrom

      Pages 201-216

6. General Management

   1. Front Matter

      Pages 217-217

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   2. Management of acute episodes of depression

      • Hilary Standish-Barry

      Pages 219-233

   3. The use of electroconvulsive therapy in elderly depressive patients

      • Katy Malcolm, Malcolm Peet

      Pages 235-251

Depression is one of the commonest problems in old age. Yet until recently, old people were systematically exduded from participating in drug trials and similar investigations. As a result, knowledge regarding incidence, natural history and management of depression in the elderly are somewhat limited. It is now well-established that old people are sensitive to most psychotropic drugs and they tend to suffer from adverse effects and side effects of antidepressant drugs more frequently than any other age group. These are considered to be due to age-related physiological changes. In addition, because of the frequent association with multiple pathology, the elderly are likely to receive polypharmacy which further complicates the management of antidepressant drug therapy. The aim of this book is to provide a comprehensive guidance on the drug therapy of depression for the dinicians involved in the health care of the elderly. In the first section, epidemiology, presentations and assessment of depression in old age and neuroendocrine abnormalities observed in patients with depression are briefly discussed. However, it mainly deals with the problems of antidepressant drug therapy, such as which antidepressant to prescribe, how to monitor efficacy and side effects, what is the adequate dose, how long to treat a single episode of depression and who requires long term medication. Information regarding pharmacology, side effects, adverse effects, drug interaction and pharmacokinetics of most currently available drugs are provided. Special emphasis has been given on continuation therapy and the choice of an antidepressant drug and their long term safety.

• depression
• drug
• kinetics
• pharmacokinetics
• pharmacology
• pharmacy

• University of Wales College of Medicine, UK

  Karabi Ghose

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