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Advances in Psychiatric Treatment (2004) 10: 131-139
© 2004 The Royal College of Psychiatrists

Management of depression in later life

Robert Baldwin and Rebecca Wild

Robert Baldwin has been a consultant in old age psychiatry at Manchester Royal Infirmary since 1985 (Manchester Mental Health & Social Care Trust, York House, Manchester Royal Infirmary, Oxford Road, Manchester M13 9BX, UK. Tel: +44 (0)161 276 5303; fax: +44 (0)161 276 5317; e-mail: Robert.Baldwin{at}man.ac.uk) and Honorary Professor of Psychiatry at the University of Manchester since 2000. His main research interest is mood disorders in later life, on which he has published widely. Rebecca Wild trained as a specialist registrar in Greater Manchester and is now a consultant in old age psychiatry at Bolton Royal Hospital in Lancashire.

Both antidepressants and psychological treatments are effective in the management of late-life depression. Nevertheless, there remains a considerable challenge to improve the prognosis for depression in older people. Endlessly increasing the range of antidepressants does not seem to be the answer, so attention is turning to new combinations of treatments and new ways of delivering care and improving treatment uptake. Collaboration between specialist and primary care, case management and multifaceted interventions are currently the most exciting prospects. There is good evidence for the role of both medication and psychological treatment in keeping the patient well after recovery.




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