[Pharmacotherapy of depression in the elderly]

Antidepressants are not only effective in younger adults but also in older persons with depression. However there are peculiarities, which have to be taken into account when treating older patients. The enhanced risk of side effects has to be balanced with the more serious consequences of an untreated depression in old age. The efficacy in older patients has been proven not only for tricyclic antidepressants but also for SSRI and other newer antidepressants. The easy handling, the side effect profile and the safety in overdose are advantages of SSRI and newer antidepressants, which become particularly important in old age. The advantages and disadvantages of different classes of antidepressants with regard to comorbidity and comedication are discussed. In older subjects, changes of dosage should be slower and for some, but not for all antidepressants, dosage should be lower.