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Case 15 - “I Feel Terrible”

SSRIs and Treatment-Resistant Depression

Published online by Cambridge University Press:  31 October 2024

Matthew Gibfried
Affiliation:
Saint Louis University School of Medicine, Missouri
George T. Grossberg
Affiliation:
Saint Louis University School of Medicine, Missouri
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Summary

Current guidelines still support the use of an SSRI as first choice for the treatment of depression in older adults. Clinicians should keep in mind the old adage “Start low, go slow, but go” with regard to the prescribing of antidepressants in older patients. With older adults, it is a good idea to start at half or quarter of the normal adult starting dose but to increase the dose to well within the therapeutic range for a given antidepressant. Depression is prevalent in older adults in long-term care with estimated prevalence from 11-45%. Depression is associated with poor overall health outcomes and poor quality of life. Interventions are often effective if these patients are identified but treatment can be challenging and require multiple adjustments in medications or treatment strategies.

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Chapter
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Clinical Case Studies in Long-Term Care Psychiatry
Navigating Common Mental Health Challenges in Geriatric Care
, pp. 73 - 77
Publisher: Cambridge University Press
Print publication year: 2024

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References

References

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Further Reading

Conroy, R., Golden, J., Jeffares, I., O’Neill, D., & Mcgee, H. (2010). Boredom-proneness, loneliness, social engagement and depression and their association with cognitive function in older people: A population study. Psychology, Health & Medicine. 15, 463473. 10.1080/13548506.2010.487103.CrossRefGoogle ScholarPubMed
Domènech-Abella, J., Mundó, J., Haro, J. M., & Rubio-Valera, M. (2019). Anxiety, depression, loneliness and social network in the elderly: Longitudinal associations from The Irish Longitudinal Study on Ageing (TILDA). Journal of Affective Disorders, 246, 8288.CrossRefGoogle ScholarPubMed
Furukawa, Y., Hamza, T., Cipriani, A., Furukawa, T., Salanti, G., & Ostinelli, E. (2022). Optimal dose of aripiprazole for augmentation therapy of antidepressant-refractory depression: Preliminary findings based on a systematic review and dose–effect meta-analysis. The British Journal of Psychiatry, 221 (2), 440447. doi:10.1192/bjp.2021.165CrossRefGoogle ScholarPubMed

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  • “I Feel Terrible”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.016
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  • “I Feel Terrible”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.016
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • “I Feel Terrible”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.016
Available formats
×