26
Informaciones
Psiquiátricas
2017 - n.º 228
efectos adversos distan de ser óptimas en
población geriátrica. Por otro lado, los datos
de eficacia de los tratamientos antidepre-
sivos en personas mayores y sobre todo en
octogenarios son limitados, puesto que esta
población está claramente infrarrepresentada
en los ensayos clínicos. En la presentación se
abordarán las aportaciones de los antidepre-
sivos que han aparecido en los últimos años
en nuestro medio al tratamiento de la depre-
sión geriátrica.
Palabras clave:
nuevos antidepresivos,
depresión, anciano.
Abstract
Young antidepressants for elderly
patients?
Depression is the most common psychia-
tric disorder in the elderly population, with
an increased prevalence in old and very old
hospitalized or institutionalized patients.
Depression in the geriatric population asso-
ciates important consequences in the form
of loss of functionality, disability, decrea-
sed quality of life, increased morbidity and
mortality, high health care costs and high
risk of suicide. Despite its impact, this cli-
nical situation is often underdiagnosed and
under-treated. The particularities of the
clinical expression of depression in elderly
patients and the difficulties in differential
diagnosis and treatment can contribute to
this improvable picture.
Among the difficulties encountered in the
psychopharmacological treatment of de-
pression in the elderly are the presence of
comorbidities with other medical diseases,
frequent polypharmacy, pharmacokinetic
and pharmacodynamic changes associated
with aging, both physiological and se-
condary to other diseases and treatments,
which confer greater vulnerability to the ap-
pearance of adverse drug reactions; as well
as the tendency to recurrences, chronicity
and refractoriness to first-line treatments.
In the last decades, with the develop-
ment of antidepressants with selective me-
chanisms of action, the general tolerability
has been improved compared to the classic
antidepressants such as tricyclics and mo-
noamine oxidase inhibitors. However, to-
lerability and adverse effects are far from
optimal in the geriatric population. On the
other hand, data about the efficacy of an-
tidepressant treatments in the elderly, and
especially in octogenarians, are limited,
since this population is clearly underrepre-
sented in clinical trials. This paper will ad-
dress the contributions of antidepressants
that have appeared in recent years in our
country to the treatment of depression in
the elderly.
Key Words:
new antidepressants, depression,
elderly.
Depresión y edad avanzada
La depresión es el trastorno psiquiátri-
co más frecuente en la población de edad
avanzada, con cifras que oscilan entre 8.6-
14.1% en referencia a síndromes de depre-
sión clínicamente significativa Vs el 1-4% de
diagnósticos de depresión mayor. De hecho,
encontramos una elevada frecuencia de sín-
dromes subclínicos al hablar de depresión
en las personas mayores. Se estima que la
depresión está presente en alrededor del 30-
45% de los pacientes ancianos afectados de
enfermedades médicas, agudas o crónicas; y
causa el 60% de los ingresos psiquiátricos
Virginia Soria
