Treatment may also include psychotherapy, says Dr. Bennett Gurian, associate professor of psychiatry at Harvard Medical School and senior consultant in geropsychiatry at Beth Israel Deaconess Medical Center in Boston. Together, medication and psychotherapy are more effective in the long term than either one alone. There are many antidepressant drugs, and each one potentially can cause a slightly different response in each person. The trick is to find the best one and the right dose. Seniors may have other illnesses or medications that complicate their reactions to some drugs.
Low doses are often necessary because of changes aging often makes to physiology.
They work by causing a temporary increase in the brain's supply of serotonin, a neurotransmitter that helps regulate mood. The SSRIs appear to be as effective as older antidepressants but have fewer and less serious side effects. Persistence Pays Close monitoring after medication is prescribed is critical, although follow-up by primary care physicians is often inadequate, says Katz. People who don't respond to a first treatment may very well benefit from a second. To help prevent a relapse, medication should be continued for at least 9 months after the depressive symptoms disappear, Katz says.