Optimizing Antidepressant Use in Geriatric Depression: Expert Consensus from French societies of geriatrics, old age psychiatry and clinical pharmacy (SFGG, SF3PA and SFPC)

BackgroundLate-life depression refers to a depression occurring in older adults, typically defined as individuals aged 65 years and older.It is common and often mismanaged due to complex clinical profiles, polypharmacy and limited evidence-based guidance.Existing tools poorly address psychiatric nuances in older adults.This work aims to develop French recommendations based on experts consensus on the use of antidepressant in unipolar late-life depression, to guide safer prescribing practicesespecially in primary care-and address a major public health issue. MethodsThis tool was developed using a Delphi survey, based on a review of literature published between 2014 and 2024 and focused on "antidepressants" and "late-life depression" available on PubMed.Experts from various fields: geriatric psychiatry, clinical pharmacy and general practice, rated items using a 9point Likert scale.Items with a median score 7 and at least 80% agreement were validated and included in the final version of the tool. ResultsTwenty to twenty-three experienced experts per round, different from the authors of the proposed items, participated in a four-round Delphi process.The resulting tool, based on evidence and clinical expertise, includes 57 validated items across 10 sections and a stepped-care algorithm for treating major depression in older adults.It addresses drug choice, dosing, monitoring, comorbidities, and treatment resistance, prioritizing safe first-line options like sertraline, citalopram, and escitalopram. ConclusionA Delphi survey involving multidisciplinary experts led to a French consensus tool for prescribing antidepressants in unipolar late-life depression.It integrates clinical evidence and expert judgment to address treatment complexity, drug safety and resistance.The tool offers practical, stepwise recommendations tailored to primary care, aiming to optimize antidepressant use, reduce iatrogenesis, and improve patient outcomes.

Authors

Institutions

Publication Details

Journal
European Psychiatry
Published
2026-03-26
DOI
https://doi.org/10.1192/j.eurpsy.2026.12206
Primary Topic
Treatment of Major Depression
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Optimizing Antidepressant Use in Geriatric Depression: Expert Consensus from French societies of geriatrics, old age psychiatry and clinical pharmacy (SFGG, SF3PA and SFPC)

Anne-Laure Debruyne, Pierre Vandel, Sandrine Louchart de la Chapelle, Sophie Armand-Branger et al.
European Psychiatry
Treatment of Major Depression
article

Optimizing Antidepressant Use in Geriatric Depression: Expert Consensus from French societies of geriatrics, old age psychiatry and clinical pharmacy (SFGG, SF3PA and SFPC)

Anne-Laure Debruyne, Pierre Vandel, Sandrine Louchart de la Chapelle, Sophie Armand-Branger, Sonia Prot-Labarthe, Jean Roche, Ilia Humbert, Quentin Gallet, Gérald Deschietere, Samuel Bulteau, Alexis Lepetit, Stéphanie Miot, Tanguy Taillefer de Laportalière, O. Drunat, Benjamin Calvet, Jean‐Pascal Fournier, A. Lepelletier, M. Houix, C. Hanon, Jean‐Michel Dorey, J. Gauillard, Jean Luc Olivier, Sylvie Bonin-Guillaume, Maximilien Redon, Thomas DESMIDT, N. Hoertel, Beatriz Pozuelo Moyano, Gabriel Robert, Frédéric Limosin, Ismael Conejero, Nicolas Marie, Christophe Arbus, Laurence Petit, Isabelle Jalenques, Mathieu Corvaisier
article en

Abstract

BackgroundLate-life depression refers to a depression occurring in older adults, typically defined as individuals aged 65 years and older.It is common and often mismanaged due to complex clinical profiles, polypharmacy and limited evidence-based guidance.Existing tools poorly address psychiatric nuances in older adults.This work aims to develop French recommendations based on experts consensus on the use of antidepressant in unipolar late-life depression, to guide safer prescribing practicesespecially in primary care-and address a major public health issue. MethodsThis tool was developed using a Delphi survey, based on a review of literature published between 2014 and 2024 and focused on "antidepressants" and "late-life depression" available on PubMed.Experts from various fields: geriatric psychiatry, clinical pharmacy and general practice, rated items using a 9point Likert scale.Items with a median score 7 and at least 80% agreement were validated and included in the final version of the tool. ResultsTwenty to twenty-three experienced experts per round, different from the authors of the proposed items, participated in a four-round Delphi process.The resulting tool, based on evidence and clinical expertise, includes 57 validated items across 10 sections and a stepped-care algorithm for treating major depression in older adults.It addresses drug choice, dosing, monitoring, comorbidities, and treatment resistance, prioritizing safe first-line options like sertraline, citalopram, and escitalopram. ConclusionA Delphi survey involving multidisciplinary experts led to a French consensus tool for prescribing antidepressants in unipolar late-life depression.It integrates clinical evidence and expert judgment to address treatment complexity, drug safety and resistance.The tool offers practical, stepwise recommendations tailored to primary care, aiming to optimize antidepressant use, reduce iatrogenesis, and improve patient outcomes.

European Psychiatry
Université de Tours (FR), Cliniques Universitaires Saint-Luc (BE), Inserm (FR), Université Fédérale de Toulouse Midi-Pyrénées (FR), Aix-Marseille Université (FR), Centre Hospitalier Universitaire de Lille (FR), Centre Hospitalier Universitaire de Nantes (FR), Centre Hospitalier Universitaire de Toulouse (FR), Centre Hospitalier Universitaire de Montpellier (FR), Assistance Publique – Hôpitaux de Paris (FR), Hôpital de Cery (CH), Hôpital Bretonneau (FR), Hospices Civils de Lyon (FR), Ministère de l'Intérieur (FR), Centre Hospitalier Universitaire d'Angers (FR), Institut Universitaire en Santé Mentale de Québec (CA), The Princess Grace Hospital (GB), Hôpital Corentin-Celton (FR), Institut de Psychiatrie et Neurosciences de Paris (FR), Etablissements de Santé Mentale (FR), Hôpital Purpan (FR), Clermont Université (FR), Hôpitaux Universitaires de Strasbourg (FR), Centre Hospitalier Guillaume Régnier (FR), Centre Hospitalier Charles Perrens (FR), Université de Limoges (FR), Université de Nîmes (FR), Nantes Université (FR), University of Lausanne (CH)
Good health and well-being
Openalex Percentile: Top 6%
Treatment of Major Depression
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.