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Titolo:
Pharmacological treatment of depression in older primary care patients: the PROSPECT algorithm
Autore:
Mulsant, BH; Alexopoulos, GS; Reynolds, CF; Katz, IR; Abrams, R; Oslin, D; Schulberg, HC;
Indirizzi:
Univ Pittsburgh, Sch Med, Intervent Res Ctr Study Late Life Mood Disorders, Pittsburgh, PA 15260 USA Univ Pittsburgh Pittsburgh PA USA 15260 sorders, Pittsburgh, PA 15260 USA Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA 15260 USA Univ Pittsburgh Pittsburgh PA USA 15260 sychiat, Pittsburgh, PA 15260 USA Pittsburgh Vet Adm Hlth Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA USA Pittsburgh Vet Adm Hlth Syst Pittsburgh PA USA n Ctr, Pittsburgh, PA USA Cornell Univ, Weill Med Coll, Intervent Res Ctr Geriatr Mood Disorders, White Plains, NY 10605 USA Cornell Univ White Plains NY USA 10605 orders, White Plains, NY 10605 USA Cornell Univ, Weill Med Coll, Dept Psychiat, White Plains, NY 10605 USA Cornell Univ White Plains NY USA 10605 ychiat, White Plains, NY 10605 USA Univ Penn, Intervent Res Ctr Depress Late Life, Philadelphia, PA 19104 USAUniv Penn Philadelphia PA USA 19104 Late Life, Philadelphia, PA 19104 USA Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 Psychiat, Philadelphia, PA 19104 USA
Titolo Testata:
INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY
fascicolo: 6, volume: 16, anno: 2001,
pagine: 585 - 592
SICI:
0885-6230(200106)16:6<585:PTODIO>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
LATE-LIFE DEPRESSION; TREATMENT-RESISTANT DEPRESSION; MAJOR DEPRESSION; ANTIDEPRESSANT EFFICACY; RANDOMIZED TRIAL; DOUBLE-BLIND; MULTICENTER; MEDICATION; SERTRALINE; AMITRIPTYLINE;
Keywords:
geriatric depression; primary care; treatment; pharmacology; pharmacotherapy; antidepressant; psychotherapy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
47
Recensione:
Indirizzi per estratti:
Indirizzo: Mulsant, BH Western Psychiat Inst & Clin, 3811 OHara St,Room E1226, Pittsburgh, PA 15213 USA Western Psychiat Inst & Clin 3811 OHara St,Room E1226 Pittsburgh PA USA 15213
Citazione:
B.H. Mulsant et al., "Pharmacological treatment of depression in older primary care patients: the PROSPECT algorithm", INT J GER P, 16(6), 2001, pp. 585-592

Abstract

PROSPECT (Prevention of Suicide in Primary care Elderly-Collaborative Trial) is testing whether a trained clinician (the 'health specialist') can work in close collaboration with a primary care physician to implement a comprehensive depression management program and improve outcomes in older depressed patients. An algorithm guiding the selection and use of antidepressant medications has been developed to assist PROSPECT health specialists. This algorithm is presented and the rationale underlying the proposed treatment sequence is discussed. The PROSPECT algorithm builds upon existing guidelines after updating them and adapting them to the special circumstances of older primary care patients. Special attention has been paid to the tolerability and the target doses of the recommended antidepressant agents and to the duration of antidepressant trials. Patients who are unable to tolerate ordo not respond to an antidepressant can be switched to another agent or betreated with interpersonal psychotherapy. Agents that produce only a partial response can be combined with other antidepressants or with interpersonal psychotherapy. Treatments for which empirical evidence exists are favored. However, treatments that are often poorly tolerated by elderly patients: are given lower priority than treatments more likely to be tolerated. Similarly, trials that are simpler to implement in primary care are favored. Copyright (C) 2001 John Wiley & Sons, Ltd.

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Documento generato il 04/04/20 alle ore 07:49:25