Heilmann K E, Wagner M, Riedel-Heller S, Maier W, Jessen F
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn.
Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät, Leipzig.
Fortschr Neurol Psychiatr. 2015 Jul;83(7):381-91. doi: 10.1055/s-0035-1553315. Epub 2015 Jul 22.
Late life depression is associated with severe health consequences, e.g. elevated risk of medical comorbidity and decreased quality of life. This paper summarizes the recommendations of the international guidelines on evidence-based pharmacological treatment of depression in late life in a systematic review. Pharmacological treatments for depression recommended by most of the guidelines, however, hardly address the issue of the possible side effects of antidepressants and other factors of multi-medication on the elderly. Different guidelines pay different degrees of attention to the specific group of geriatric patients. There is a lack of evidence-based treatment recommendation that takes into consideration the specific age-related issues of sensitivity to adverse effects or pharmacokinetic interaction. Further research is required to provide a database for more refined recommendations in guidelines.
晚年抑郁症与严重的健康后果相关，例如患内科合并症的风险升高及生活质量下降。本文通过系统综述总结了国际指南中关于晚年抑郁症循证药物治疗的建议。然而，大多数指南推荐的抑郁症药物治疗几乎未涉及抗抑郁药可能的副作用以及多重用药的其他因素对老年人的影响问题。不同指南对老年患者这一特定群体的关注程度不同。缺乏考虑到与年龄相关的不良反应敏感性或药代动力学相互作用等特定问题的循证治疗建议。需要进一步研究以提供数据库，以便在指南中给出更精确的建议。
