Absolute treatment-resistant depression in the elderly may be less common than previously estimated if patients receive careful and vigorous treatment.
May lower estimated TRD prevalence in elderly with optimal care; leaves open prospective validation of absolute resistance rates.
Apparent treatment-resistant depression (TRD) is frequently encountered by and poses particular challenges for the old-age psychiatrist. The prevalence of true nonresponse to treatment is not known with accuracy but reports put it at 18% to 40% for the elderly. This article reviews the concept of TRD in the elderly, discussing the factors involved in apparent resistance and the treatment of this group. We suggest that absolute TRD may be a rarer entity than the estimated 18% to 40% if depressed patients are treated carefully and vigorously.
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Bonner et al. (1995) studied this question.
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