Antidepressants with a Dual Mechanism of Action and Advanced Age

Summary

Depression is very frequent in old people, according to epidemiological studies its occurs in10-15 %. In old people living in medical or social institutions it is even more frequent.In old age also more severe forms of depression are encountered more frequently, and resistanceand a chronic course are more frequent. Despite this, depression in old people is often inadequately diagnosed and frequently not adequately treated.The new generation of antidepressants (e.g. SSRI) have eliminated the disadvantages of classicalantidepressants such as the adverse spectrum of undesirable effects, suicidal risk etc. As regardseffectiveness they have not contributed much.The subsequent generation of antidepressants with dual action raises new hopes. The authorspresent hitherto published work on milnacipran, venlafaxin and mitrazapin and draw attentionto their possible use in gerontopsychiatry. Antidepressants with a dual effect have an effectivityat least comparable with classical ones, they have however a more rapid onset of action as well asa favourable spectrum of undesirable effects . It seems that they exert a favourable effect also oninhibited and anxiety depressions.

Key words:
depression in the aged, dual action of antidepressants, milnacipran, venlafaxin, mirtazapin.