Late-Life Depression Treatment: the State of the Art

Purpose: to present an overview of domestic and foreign current research covering the treatment of late-life depression. Materials and method: the keywords “depressive disorder”, “late age”, “psychopharmacotherapy” were used to search for scientific articles in the databases MedLine, PubMed for the period 2000–2020. Discussion and conclusions: the variability of multiple aging factors in depressive patients of late age leads to significant heterogeneity of geriatric depressions and difficulties in selection of therapy. In the current literature on the treatment of late-life depression, there are quite heterogeneous recommendations on the choice of different drugs, recommended dosages, duration of therapy and time to replace drugs if they are ineffective. The global trend of transition to personalized therapy of mental diseases requires identification of predictors of therapeutic response in patients. Significant data has already been accumulated on potential predictors of therapeutic response to antidepressants in young and middle-aged patients using clinical, neurobiological, neurocognitive and genetic parameters. The search for predictors of therapeutic response is especially important in late life, since the selection of adequate antidepressant therapy is associated not only with the effectiveness, but also with the safety of treatment of elderly patients. To date our knowledge of the problem of predicting the therapeutic response in this group of patients remains very limited and requires further study