Pharmacotherapy of geriatric depression.

Dysthymic disorders and major depressions both occur in the elderly. Aggressive but carefully chosen and monitored pharmacologic treatment is indicated in elderly patients with even modest symptoms of depression. Careful attention must be given to the presence of other medical disorders and treatments, physiologic changes of aging, decreased dosage requirements, and side effects. The available antidepressants are compared in terms of their effects on neurotransmitter reuptake mechanisms and the likelihood of producing sedation, anticholinergic effects, and cardiotoxicity. The low anticholinergic potential of desipramine makes it a useful drug in the treatment of geriatric depression.