James M. Ellison, MD, MPH
Associate Professor of Psychiatry
Harvard Medical School
Clinical Director, Geriatric Psychiatry Program
McLean Hospital, Belmont, MA
Richard C. Berchou, PharmD
and Assistant Professor
Department of Psychiatry and Behavioral Neurosciences
Wayne State University, Detroit, MI
Physician & Pharmacist: 1 hour, Nurse & NP: 1.2
This program was first released as a live audioconference (ACPE #203-999-04-117-C01) presented in December 2004 and January 2005. If you participated in and received credit for the live version of the program, you are not eligible to receive credit for this version of the same program.
Depression in the elderly can go undetected or be undertreated for several reasons. Some consider low energy and reduced activity normal aspects of aging or do not realize how readily depression can respond to treatment. Depression in the elderly can also be difficult to recognize, in part because it may present with ambiguous physical or psychiatric symptoms common to other conditions. Untreated depression diminishes quality of life, impairs performance, and increases mortality.
Fortunately, depressive illness in later life is highly treatable in all settings including primary care and specialized mental health and long-term care settings. Pharmacologic and psychotherapeutic interventions that are appropriate for the geriatric patient should be employed. The choice of treatment strategy should be tailored to each patient. The primary care or psychiatric prescribing clinician’s work is often enhanced by collaboration with a psychotherapist and consultant pharmacist. The combination of expertise can improve both clinical outcome and cost-effectiveness of treatment.
This program will review the presentation and symptoms of depression in the elderly, contrasting depression with anxiety states, which are separate (though often comorbid) illnesses that may be mistaken for depression. Pharmacologic treatments and the role of psychotherapy will be reviewed, as will strategies for tailoring individual treatment plans. Early recognition will be emphasized, with a discussion of rating scales and patient history in the differential diagnosis of affective disorders. Case studies will be discussed in a problem-based format to illustrate these concepts.
. Target Audience
Long-term care medical directors, consultant and VA pharmacists, long-term care nurses and nurse practitioners.
Upon completion of this educational activity, the participant should be able to:
Discuss diagnostic clues, assessment techniques and tools needed for early identification of depression in the elderly
Discuss the impact of comorbid anxiety on diagnosis and treatment of depression in this population
Choose evidence-based pharmaco- and psychotherapeutic options for elderly individuals suffering from depressive and anxiety disorders
Implement comprehensive individualized management strategies that consider both pharmacologic and psychotherapeutic treatment options
Dr. Ellison discloses that he has received remuneration for participation in speakers’ bureaus for Pfizer Inc, Wyeth Pharmaceuticals, Forest Laboratories, Inc., GlaxoSmithKline, and Bristol-Myers Squibb. He has participated in funded research for GlaxoSmithKline, and Cephalon, Inc.
Dr. Berchou discloses that he has received remuneration for participation in speakers’ bureaus for Janssen Pharmaceutica Inc., Eli Lilly and Company, AstraZeneca, Wyeth Pharmaceuticals, and Bristol-Myers Squibb Company. He is also on an advisory board for Eli Lilly and Company.
The faculty discusses off-label, unapproved and/or investigational uses of pharmaceutical products in this presentation.
This program (#203-999-04-117-H01) was developed by the American Society of Consultant Pharmacists (ASCP) and is approved for 1.0 Contact Hour (0.1 CEU). ASCP is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education.
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of AKH Inc. and Medical Communications Media, Inc. AKH Inc. is accredited by the ACCME to provide continuing medical education for physicians.
AKH Inc. designates this educational activity for a maximum of 1 category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.
This program has been approved for 1.2 hours of continuing nursing education by AKH Inc. AKH Inc. is accredited as a provider of continuing education in nursing by the American Nurses Credentialing Center's Commission on Accreditation, and is an approved provider through the Boards of Nursing in CA, #CEP12070, & IA, #277.
This program has been approved for 1.2 hours of continuing education for nurse practitioners by AKH Inc. AKH Inc. is approved as a provider of nursing and nurse practitioner continuing education by the American Academy of Nurse Practitioners. #030803.
AAPA accepts Category I CME credit for the PRA from organizations accredited by ACCME. All programs on cmecorner.com which carry ACCME Category I CME credit are acceptable towards the PA Category I (Preapproved) CME requirement.
PAs requesting credit should check the “Physician” box on the post-test.
Commercial Support Statements
Supported by an unrestricted educational grant from Pfizer Inc.
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Instructions for completing and submitting the post-test are provided on the post-test screen. A minimum score of 70% on the post-test is required for a CME or CE certificate.
None of the contents may be reproduced in any form without prior written permission of the publisher. The opinions expressed in this publication and audioconference are those of the speakers and do not necessarily reflect the opinions or recommendations of their affiliated institutions, the publisher, the American Society of Consultant Pharmacists, AKH, Inc., or Pfizer Inc. Any medications, or other diagnostic or treatment procedures discussed by the program speakers should not be utilized by clinicians without evaluation of their patients’ conditions and of possible contraindications or risks, and without a review of any applicable manufacturer’s product information and comparison with the recommendations of other authorities.