[Depression in the elderly. Rigorous evaluation of drug treatment]

There is a general consensus on two points: it takes about 2 months for symptoms to resolve; treatment for 4 to 6 months thereafter reduces the risk of relapse. The same dose should be used for both periods. Likewise for prophylaxis against recurrent depression (long-term treatment for several years).

There are three major risks in elderly patients with depression: relapse, chronic depression, suicide. Improved quality care for depressive patients is a major public health issue. It is essential to recognize affected patients who require regular care in order to reduce the risk of non-observance (30-70% of the cases).

Differentiate minor depression from major depression. Wait 7 days before evaluating drug efficacy. Be aware of the risk of desinhibition. See the patient and his/her relations often. Take steps to prevent suicide using appropriate drugs. Favor psychological counseling. Use single-drug regimens preferentially. Prescribe for a sufficiently long period (life?).