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1. Which of the following is NOT a risk
factor for depression in the elderly?
a) Social isolation.
b) Uncontrolled pain.
c) High socio-economic status.
2. Which of the following is NOT a risk
factor for symptoms of depression?
b) Folate deficiency.
d) Vitamin B12 deficiency.
e) None – all of these can cause
symptoms of depression.
3. Which of the following statements is
a) Depression is a normal consequence
b) Elderly patients are more likely
to suffer adverse effects from
c) The Geriatric Depression Scale is a
useful tool in assessing depression in
d) Elderly patients with depression may
have atypical symptoms.
4. In regards to treatment of
depression in the elderly, which
of the following is recommended
as first-line treatment for mild
5. Which of the following
antidepressant medications is MOST
COMMONLY associated with causing
a) Tricyclic antidepressants.
b) Selective serotonin reuptake
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2012(11):Art. No.: CD006727.
3. Holroyd S, Clayton AH. Measuring depression in the elderly: which scale
is best. Medscape General Medicines. 2000;2(4).
4. Aged Care Companion: Depression. Australian Medicines Handbook;
2012 [cited 2013 Mar]; At: https://www.amh.net.au/agedcare/view.php?
5. Mottram PG, Wilson K, Strobl JL. Antidepressants for depressed elderly.
Cochrane Database of Systematic Reviews. 2006(1):Art. No.: CD003491.
6. Wilson K, Mottram PG, Sivananthan A, Nightingale A. Antidepressants
versus placebo for depressed elderly. Cochrane Database of Systematic
Reviews. 2001(1):Art. No.: CD00561.
7. Cole MG, Dendukuri N. Risk factors for depression among elderly
community subjects: a systematic review and meta-analysis. Am J
8. Anderson IM. Meta-analytical studies on new antidepressants. British
Medical Bulletin. 2001;57:161–78.
9. Depression – challenges in primary care. NPS News. 2012;78:1–4 .
10. Butler R, Hatcher S, Price J, Von Korff M. Depression in adults:
psychological treatments and care pathways. Clinical Evidence.
11. Therapeutic Guidelines: Principals of treatment for depression [CD].
Melbourne: Therapeutic Guidelines; 2012.
12. Wei W, Sambamoorthi U, Olfson M, Walkup JT, Crystal S. Use of
psychotherapy in depression in older adults. Am J Psychiatry.
13. Van Etten D. Psychotherapy with older adults - benefits and barriers.
Journal of Psychosocial Nursing and Mental Health Services.
14. Therapeutic Guidelines: Psychological interventions for psychiatric
illness: introduction [CD]. Melbourne: Therapeutic Guidelines Limited;
15. Therapeutic Guidelines: Cognitive behavioural therapy [CD].
Melbourne: Therapeutic Guidelines Limited; 2012.
16. Therapeutic Guidelines: Interpersonal therapy [CD]. Melbourne:
Therapeutic Guidelines Limited; 2012.
17. Australian Medicines Handbook: Major depression. Adelaide:
Australian Medicines Handbook Pty Ltd; 2013 [cited 2013 Mar].
18. Therapeutic Guidelines: Pharmacological treatment of depression:
general considerations [CD]. Melbourne: Therapeutic Guidelines; 2012.
19. Wiese BS. Geriatric depression: the use of antidepressants in the elderly.
BCMJ. 2011;53(7):341–7 .
20. Spina E, Scordo MG. Clinically significant drug interactions with
antidepressants in the elderly. Drugs Aging. 2002;19(4):299–320.
21. Kairuz T, Zolezzi M, Fernando A. Clinical considerations of
antidepressant prescribing for older patients. The New Zealand
Medical Journal. 2005;118(1222).
22. National Institute for Health and Clinical Excellence. The treatment
and management of depression in adults (updated version). National
Clinical Practice Guideline 90.: National Institute for Health and Clinical
23. Coupland C, Dhiman P, Morris R, Arthur A, Barton G, Hippisley-Cox J.
Antidepressant use and the risk of adverse outcomes in older people:
population based cohort study. BMJ. 2011;343:d4451.
24. Australian Medicines Handbook: Tricyclic antidepressants. Adelaide:
Australian Medicines Handbook Pty Ltd; 2013 [cited 2013 Mar].
25. Aged Care Companion: Drugs with anticholinergic effects. Australian
Medicines Handbook; 2012 [cited 2013 June]; At: https://www.amh.
26. Australian Medicines Handbook: Mirtazapine. Adelaide: Australian
Medicines Handbook; 2013 [cited 2013 Mar].
Depression is underdiagnosed
and undertreated in the elderly.
Pharmacists are well placed to speak
with elderly patients about depression
and identify those who may be at risk.
They can also speak with patients
who are being treated for depression
to ensure their treatment is effective
and adverse effects are minimised.
Pharmacists performing medication
reviews for elderly patients with
depression should assess which (if
any) antidepressant medication or
non-drug treatment is appropriate
for that patient with consideration of
comorbidities and other medications.
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