Optimizing antidepressant use in geriatric depression: expert consensus from French societies of geriatrics, old age psychiatry, and clinical pharmacy (SFGG, SF3PA, and SFPC)
SFGG/SF3PA/SFPC · 2026 · France
Source and licence
- Authors
- Morgane Houix, Alexis Lepetit, Christophe Arbus et al.
- Title
- Optimizing antidepressant use in geriatric depression: expert consensus from French societies of geriatrics, old age psychiatry, and clinical pharmacy (SFGG, SF3PA, and SFPC)
- Journal
- European Psychiatry, 2026
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC13372736
Licence statement of the original publication
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.
Open the original publication →Full text on Europe PMC
Recommendations
We found no explicitly labelled recommendations in this publication; its recommendations are in the running text of the original.
Abstract
Background: Late-life depression refers to a depression occurring in older adults, 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 antidepressants in unipolar late-life depression, to guide safer prescribing practices.
Methods: This 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” Experts from various fields: geriatric psychiatry, clinical pharmacy and general practice, rated items using a 9-point Likert scale. Items with a median score ≥ 7 and at least 80% agreement were validated and included in the final version of the tool.
Results: Twenty to 23 experts per round, different from the authors of the proposed items, participated in a four-round Delphi process. The resulting tool 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.
Conclusion: A 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.
Contents of the original publication
The section headings of the original.
- Keypoints for clinicians
- Introduction
- Materials and methods
- Development of the items
- Selection of the expert group
- Data collection
- Procedure
- Regulatory considerations
- Results
- Participating experts
- Discussion
- Expert consensus process and outcomes
- Management of treatment-resistant depression
- Safety considerations in antidepressant selection
- Items lacking consensus and future research directions
- Limitations and implementation considerations
- Conclusion
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