Treatment of depression in the elderly: a Canadian view

1. Between 10 and 15% of people over the age of 65 have a potentially treatable depression. 2. The commonest antidepressants used in Canada, the tertiary-amine tricyclics, are potentially problematic when used with geriatric patients. 3. It is current practice in geriatric psychiatry to use secondary-amine tricyclics as "first choice" drugs for elderly depressed patients. 4. Electroconvulsive therapy can be effectively used to deal with severely depressed elderly patients, particularly if there are also features of dementia. 5. Although "better drugs" are needed for the elderly, people over the age of 65 are typically excluded from treatment outcome research.