Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-24T16:27:14.746Z Has data issue: false hasContentIssue false

Chapter 10 - Combining Psychotherapy and Medications for Late-Life Psychiatric Disorders

from Part 3 - Special Topics in Psychotherapy in Later Life

Published online by Cambridge University Press:  09 January 2020

By
Meera Balasubramaniam ,
Deepti Anbarasan  and
Paul Campion
Edited by
Rajesh R. Tampi ,
Brandon Yarns ,
Kristina F. Zdanys  and
Deena J. Tampi
Rajesh R. Tampi
Affiliation:
Case Western Reserve University, Ohio
Brandon Yarns
Affiliation:
VA Greater Los Angeles Healthcare System
Kristina F. Zdanys
Affiliation:
University of Connecticut
Deena J. Tampi
Affiliation:
Diamond Healthcare Corporation
Get access

Summary

The role of doctors is commonly limited to prescribing medications. However, formulating the psychological component of an elderly patient’s presentation remains of crucial importance. This chapter explores common potential psychological sources of treatment-resistant symptoms through a clinical vignette. The literature is reviewed regarding the combination of medication management and psychotherapy for depression and anxiety.

Keywords

psychotherapycombinationpsychopharmacologytreatment resistancetherapeutic alliance
Type
Chapter
Information
Psychotherapy in Later Life , pp. 150 - 157
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Warden, D, Rush, AJ, Trivedi, MH, Fava, M, Wisniewski, SR. The STAR*D project results: a comprehensive review of findings. Current Psychiatry Reports. 2007 Dec 1;9(6):449–459.Google Scholar
Drapeau, M, Perry, JC. Childhood trauma and adult interpersonal functioning: a study using the core conflictual relationship theme method (CCRT). Child Abuse & Neglect. 2004 Oct 1;28(10):1049–1066.Google Scholar
Zisook, S, Johnson, GR, Tal, I, et al. General predictors and moderators of depression remission: a VAST-D report. Am J Psychiatry. 2019 Apr 5;appiajp201818091079.Google Scholar
Gabbard, GO. Psychodynamic psychiatry in the” decade of the brain.” Am J Psychiatry. 1992 Aug;149(8):991–998.Google Scholar
Vlastelica, M. Psychodynamic approach as a creative factor in psychopharmacotherapy. Psychiatria Danubina. 2013 Sep 17;25(3):0–319.Google Scholar
Mintz, DL, Flynn, DF. How (not what) to prescribe: nonpharmacologic aspects of psychopharmacology. Psychiatric Clinics. 2012 Mar 1;35(1):143–163.Google Scholar
Krell, HV, Leuchter, AF, Morgan, M, Cook, IA, Abrams, M. Subject expectations of treatment effectiveness and outcome of treatment with an experimental antidepressant. J Clin Psychiatry. 2004 Sep;65(9):1174–1179.Google Scholar
Mintz, D, Belnap, B. A view from Riggs: treatment resistance and patient authority – III. What is psychodynamic psychopharmacology? An approach to pharmacologic treatment resistance. J Am Acad Psychoanal Dyn Psychiatry. 2006 Dec;34(4):581–601.Google Scholar
Leigh, R, Varghese, F. Psychodynamic psychotherapy with the elderly. J Psychiatr Pract. 2001 Jul 1;7(4):229–237.CrossRefGoogle ScholarPubMed
Atiq, R. Common themes and issues in geriatric psychotherapy. Psychiatry (Edgmont). 2006 Jun;3(6):53.Google Scholar
Comninos, A, Grenyer, BF. The influence of interpersonal factors on the speed of recovery from major depression. Psychother Res. 2007 Mar 1;17(2):230–239.Google Scholar
National Institute for Health and Clinical Excellence. Depression: management of depression in primary and secondary care. NICE; 2004.Google Scholar
Reynolds, CF 3rd, Frank, E, Perel, JM, et al. Nortriptyline and interpersonal psychotherapy as maintenance therapies for recurrent major depression: a randomized controlled trial in patients older than 59 years. JAMA. 1999b;281:39–45.Google Scholar
Lenze, EJ, Dew, MA, Mazumdar, S, et al. Combined pharmacotherapy and psychotherapy as maintenance treatment for late-life depression: effects on social adjustment. Am J Psychiatry. 2002 Mar;159(3):466–468.Google Scholar
Thompson, LW, Coon, DW, Gallagher-Thompson, D, Sommer, BR, Koin, D. Comparison of desipramine and cognitive/behavioral therapy in the treatment of elderly outpatients with mild-to-moderate depression. Am J Geriatr Psychiatry. 2001;9:225–240.Google Scholar
Hollon, SD, Jarrett, RB, Nierenberg, AA, et al. Psychotherapy and medication in the treatment of adult and geriatric depression: which monotherapy or combined treatment? J Clin Psychiatry. 2005 Apr;66(4):455–468.CrossRefGoogle ScholarPubMed
Schuurmans, J, Comijs, H, Emmelkamp, PM, et al. A randomized, controlled trial of the effectiveness of cognitive-behavioral therapy and sertraline versus a waitlist control group for anxiety disorders in older adults. Am J Geriatr Psychiatry. 2006;14:255–263.Google Scholar
Schuurmans, J, Comijs, H, Emmelkamp, PM, et al. Long-term effectiveness and prediction of treatment outcome in cognitive behavioral therapy and sertraline for late-life anxiety disorders. Int Psychogeriatr. 2009;21:1148–1159.Google Scholar
Wetherell, JL, Stoddard, JA, White, KS, et al. Augmenting antidepressant medication with modular CBT for geriatric generalized anxiety disorder: a pilot study. Int J Geriatr Psychiatry. 2011 Aug;26(8):869–875.Google Scholar
Wetherell, JL, Petkus, AJ, White, KS, et al. Antidepressant medication augmented with cognitive-behavioral therapy for generalized anxiety disorder in older adults. Am J Psychiatry. 2013 Jul;170(7):782–789.Google Scholar
Pinquart, M, Duberstein, PR. Treatment of anxiety disorders in older adults: a meta-analytic comparison of behavioral and pharmacological interventions. Am J Geriatr Psychiatry. 2007 Aug;15(8):639–651.CrossRefGoogle ScholarPubMed
Erikson, E. Identity and the Life Cycle. New York: W.W. Norton; 1980.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×