Therapy Choices for Late-Life Depression

Late-life depression has a chronic course and is often complicated by coexistent medical conditions, of which anxiety is the most common. Clinical evidence exists for the efficacy of tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) in late-life depression. Unlike TCAs, SSRIs benefit from a benign tolerability profile and are not associated with adverse cardiovascular effects, anticholinergic activity, or significant sedative properties. The choice of SSRI for latelife depression should take into account pharmacokinetic differences between SSRIs that confer additional safety and tolerability advantages.