Gerontology & Geriatric Research

Innovations in Pharmacological Approaches to Geriatric Depression

Mercia Franny^* Department of Pathology, Stanford University School of Medicine, Stanford, USA
^*Correspondence: Mercia Franny, Department of Pathology, Stanford University School of Medicine, Stanford, USA, Email:

Received: 01-Aug-2023, Manuscript No. jggr-23-22788; Editor assigned: 03-Aug-2023, Pre QC No. P-22788; Reviewed: 16-Aug-2023, QC No. Q-22788; Revised: 21-Aug-2023, Manuscript No. R-22788; Published: 28-Aug-2023, DOI: 10.35248/2167-7182.2023.12.689

Description

Geriatric depression, also known as late-life depression or elderly depression, is a prevalent and serious mental health issue affecting older adults worldwide. As the global population continues to age, the burden of geriatric depression is expected to increase, necessitating innovative approaches to its management. Pharmacological interventions have long been a cornerstone of treatment for depression in the elderly population. However, due to age-related changes in physiology, comorbid medical conditions, and the potential for drug interactions, the management of geriatric depression requires unique considerations. This article delves into recent innovations in pharmacological approaches to geriatric depression, highlighting advancements in drug development, personalized medicine, and the incorporation of novel treatment modalities [1,2].

Geriatric depression presents distinct challenges compared to depression in younger populations. Physiological changes associated with aging, such as alterations in drug metabolism, decreased liver and renal function, and changes in body composition, can impact the pharmacokinetics and pharmacodynamics of antidepressant medications. These changes can lead to altered drug efficacy and an increased risk of adverse effects. Moreover, the presence of comorbid medical conditions, such as cardiovascular disease, diabetes, and neurodegenerative disorders, further complicates treatment decisions. Polypharmacy, the concurrent use of multiple medications, is common among older adults, heightening the potential for drug interactions and adverse events.

In recent years, there has been a push for the development of antidepressant medications that are specifically tailored to the needs of the elderly population. Traditionally, Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) have been the mainstay of treatment. However, newer classes of antidepressants are being explored to address the unique challenges of geriatric depression. This novel antidepressant works through a melatonergic agonist and a serotonergic antagonist mechanism. It not only exhibits antidepressant properties but also has a positive impact on sleep patterns, making it particularly appealing for elderly patients who often suffer from sleep disturbances. Agomelatine's dual mechanism of action distinguishes it from traditional antidepressants and makes it a promising option for geriatric depression.Insufficient sleep has been linked to various physical health issues. In children and adolescents, chronic sleep deprivation is associated with impaired growth, weakened immune function, increased risk of obesity, and elevated blood pressure. This medication acts as a multimodal antidepressant by targeting various serotonin receptors. Its cognitive-enhancing effects are of particular interest in geriatric depression, where cognitive deficits are often pronounced. Vortioxetine's potential to improve cognitive function sets it apart as a valuable option for older adults with depression. The concept of personalized medicine involves tailoring treatment decisions to an individual's unique characteristics, including their genetic makeup, biomarker profile, and other clinical parameters. In geriatric depression, this approach gains significance due to the heterogeneity of the elderly population and their varying responses to treatment.

Growing evidence suggests a link between inflammation and depression, particularly in the elderly population. Inflammatory biomarkers such as C-reactive Protein (CRP) and interleukin-6 (IL-6) have been associated with treatment-resistant depression in older adults. Targeting inflammation through adjunctive antiinflammatory agents might offer a novel approach to managing geriatric depression. In addition to traditional antidepressant medications, innovative approaches are being explored to enhance treatment outcomes in geriatric depression. These approaches often complement pharmacological interventions and address the multifaceted nature of the condition. While traditionally used as an aesthetic, ketamine has gained attention for its rapid antidepressant effects, even in treatment-resistant depression. Ketamine infusion therapy has shown promise in improving depressive symptoms in older adults as well. Its unique mechanism of action, which targets the glutamatergic system, sets it apart from conventional antidepressants. Mindfulness-Based Interventions: Mindfulnessbased interventions, such as Mindfulness-Based Cognitive Therapy (MBCT) and Mindfulness-Based Stress Reduction (MBSR), have demonstrated efficacy in reducing depressive symptoms. These interventions promote emotional regulation and resilience, which are particularly relevant to the emotional challenges faced by older adults. ECT, often considered a last resort, remains a valuable option for severe and treatment-resistant geriatric depression. Modern ECT techniques have evolved to minimize cognitive side effects, making it a safer and more viable treatment for older adults who do not respond to other interventions. Innovations in pharmacological approaches to geriatric depression reflect the evolving landscape of mental health care for older adults. The challenges posed by age-related physiological changes, comorbid medical conditions, and polypharmacy are being met with advancements in drug development, personalized medicine, and novel treatment modalities. As our understanding of the biological underpinnings of geriatric depression deepens, the potential for tailored and effective interventions continues to expand. A holistic approach that integrates pharmacological innovations with psychotherapy, lifestyle modifications, and support from caregivers can pave the way for improved outcomes and enhanced quality of life for elderly individuals struggling with depression [3-5].

Acknowledgement

None.

Conflict of Interest

None.

References

1. Haraldstad K, Wahl A, Andenæs R, Andersen JR, Andersen MH, Beisland E, et al. A systematic review of quality of life research in medicine and health sciences. Qual Life Res 2019; 28:2641-250.

Google Scholar, Crossref, Indexed at

2. Fanakidou I, Zyga S, Alikari V, Tsironi M, Stathoulis J, Theofilou P. Mental health, loneliness, and illness perception outcomes in quality of life among young breast cancer patients after mastectomy: The role of breast reconstruction. Qual Life Res 2018; 27:539-543.

Google Scholar, Crossref, Indexed at

3. Lukas PS, Krummenacher R, Biasiutti FD, Begré S, Znoj H, von Känel R. Association of fatigue and psychological distress with quality of life in patients with a previous venous thromboembolic event. Thromb Haemost 2009; 102:1219-1226.

Google Scholar, Crossref, Indexed at

4. Elias A, Mallett S, Daoud-Elias M, Poggi JN, Clarke M. Prognostic models in acute pulmonary embolism: A systematic review and meta-analysis. BMJ open 2016; 6:010324.

Google Scholar, Crossref, Indexed at

5. Keller K, Tesche C, Gerhold‐Ay A, Nickels S, Klok FA, Rappold L, et al. Quality of life and functional limitations after pulmonary embolism and its prognostic relevance. J Thromb Haemost 2019; 17:1923-1934.

Google Scholar, Crossref, Indexed at