Office management of late-life depression

Depression is often misunderstood and underappreciated as a genuine clinical entity throughout the life cycle. In elderly persons especially, it can be underdiagnosed and undertreated. Office physicians are the most important resource for early intervention in late-life depression where results can be as successful as with younger age groups. Physician awareness of the normal biopsychosocial changes of late life is essential to skillful assessment and intervention since somatic disorders and their symptoms frequently overlap those of psychological origin. Tricyclic antidepressant drugs remain the core of modern medical intervention, but their appropriate use in elderly patients requires special care and finesse on the part of office-based physicians.