노년기 우울증에서의 항우울제 치료에 대한 고찰 (Review of Antidepressants Treatment in Late-Life Depression)

서지정보

· 발행기관 : 대한노인정신의학회
· 수록지 정보 : 노인정신의학 / 17권 / 1호 / 8 ~ 13페이지
· 저자명 : 윤지호, 박상진

초록

Late-life depression (LLD) refers to depressive syndromes defined in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and in the International Classification of Diseases-10 (ICD-10) that arise in adults older than age 65 years. LLD often affects people with chronic medical diseases, cognitive impairment, or other forms of disability. The phenomenology of LLD differs in part from that of early-life depression. Antidepressants appear to have a neutral or protective effect against suicidal ideation or behavior in the elderly despite having the risk of opposite effect in children, adolescents, and young adults. The treatment of depression may be divided into acute, continuation, and maintenance phases. Currently available antidepressant medications represent several classes of agents with similar antidepressant efficacy. Differences in side effect profile, interactions, and out-of-pocket cost are important determinants in the choice of medication for an elderly patient. To minimize side effects, starting doses for older adults may be lower than those for younger adults, but older adults often require full adults doses for an adequate response. Antidepressants are as effective when given to elderly individuals as they are when given to younger adults. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) the antidepressants of choice, followed by bupropion, and mirtazapine. Tricyclic antidepressants (TCAs) are effective but are no longer considered to be first-line treatments because of their side effects.

영어초록

Late-life depression (LLD) refers to depressive syndromes defined in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and in the International Classification of Diseases-10 (ICD-10) that arise in adults older than age 65 years. LLD often affects people with chronic medical diseases, cognitive impairment, or other forms of disability. The phenomenology of LLD differs in part from that of early-life depression. Antidepressants appear to have a neutral or protective effect against suicidal ideation or behavior in the elderly despite having the risk of opposite effect in children, adolescents, and young adults. The treatment of depression may be divided into acute, continuation, and maintenance phases. Currently available antidepressant medications represent several classes of agents with similar antidepressant efficacy. Differences in side effect profile, interactions, and out-of-pocket cost are important determinants in the choice of medication for an elderly patient. To minimize side effects, starting doses for older adults may be lower than those for younger adults, but older adults often require full adults doses for an adequate response. Antidepressants are as effective when given to elderly individuals as they are when given to younger adults. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) the antidepressants of choice, followed by bupropion, and mirtazapine. Tricyclic antidepressants (TCAs) are effective but are no longer considered to be first-line treatments because of their side effects.

참고자료

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