Effectiveness of pharmacological and non-pharmacological interventions for treatment-resistant depression in older patients: a systematic review and meta-analysis.
BMJ mental health March 3, 2025 Alice Jane Larsen, Giulia Teobaldi, Rosario Isabel Espinoza Jeraldo et al. 10 citations
Depression in older adults is often undertreated. An updated systematic review and meta-analysis of 14 randomized controlled trials involving 1196 participants aged 55 and older with treatment-resistant depression found that, compared with placebo, those receiving active interventions were more likely to achieve remission (odds ratio 2.42). Ketamine therapy showed a significant benefit (odds ratio 2.91), while transcranial magnetic stimulation, selegiline, aripiprazole augmentation, pharmacogenetic-guided prescribing, and cognitive remediation showed trends or weak evidence favoring intervention. The authors note a lack of evidence for routinely prescribed antidepressants and psychosocial treatments in this population, forcing clinicians to rely on data from younger adults.