Treatment of Depression in the Elderly

• In- or out-patients of 65 years of age or above fulfilling the International Classification of Diseases-Tenth Edition (ICD-10) diagnosis of depressive single episode (F32.00-32.11. 32.8 or 32.9), depressive recurrent episode (F33.00-33.11, 33.8 or 33.9) or organic depressive episode (F06.32).
• The depressive state should be mild to moderate and reach a score on HAM-D6 of ≥ 7 and ≤ 11
• Patients with dementia can be included provided they have a mini mental state exam (MMSE) score of ≥ 17

Exclusion Criteria:

• Patients with a current depressive episode of a severity reaching a score of ≥ 12 on the HAM-D6-item depression factor. This is to exclude patients with severe or psychotic depression
• Patients with suicidal thoughts or behaviour
• Patients with conditions where treatment with escitalopram is contraindicated: e.g. hypersensitivity to escitalopram or other contents of escitalopram tablets, concomitant treatment with non-selective, irreversible mono-amine-oxidase inhibitors, such as Marplan
• Patients who in the current depressive episode have had a failed trial of treatment with escitalopram
• Co-morbid dementia with a severity corresponding to a score on the MMSE of less than 17 as these patients will often be without the ability to give informed consent
• Patients with sensory defects rendering psychometric assessment impossible, e.g. deafness, blindness, severe aphasia
• Patients who cannot speak Danish well enough to make psychometric assessment possible and meaningful
• Patients with congenital or early acquired intellectual deficits