[Depression and anxiety in the elderly still underdiagnosed. SSRI preparations in conjunction with psychotherapy...

Depression and anxiety disorders in the elderly are common and under-diagnosed. As depressed elderly people often present with more somatic than psychiatric symptoms, diagnosis is difficult for the general practitioner. The Geriatric Depression Scale can be used as a screening instrument for diagnosis in the elderly. The etiology of depression and anxiety disorders is multifactorial. Important risk factors are psychological stress, reduced absorption of essential nutrients such as folacin and vitamin B12, and biological changes in the brain associated with aging. Selective serotonin reuptake inhibitors (SSRIs) are the drugs of choice in the treatment of elderly people with depression and anxiety disorders. Currently, the most widely used SSRI is citalopram, which according to controlled trials has an effect not only on depressed mood but also on anxiety. The use of SSRIs combined with support and psychotherapy elicits a positive response in nearly 90% of elderly patients. In Sweden, the use of antidepressants is currently most common in the age group 75-80 years, expressed in DDD (defined daily doses/1,000 inhabitants). This indicates a fairly active treatment of the elderly in Sweden.