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Clinical Crossroads Update
March 10, 2004

Update: A 75-Year-Old Man With Depression

JAMA. 2004;291(10):1260. doi:10.1001/jama.291.10.1260

In a Clinical Crossroads article published in March 2002, Kurt Kroenke, MD, discussed the prevalence, natural history, differential diagnosis, evaluation, and treatment of depression in older adults.1 The patient, Mr S, had been having difficulties with depression for about 2½ years following coronary artery bypass graft surgery and subsequent complications. About 2 years earlier, Mr S started taking venlafaxine XR (75 mg/d) with initial improvement of his symptoms. However, even with an increase in the dose, his depression worsened. He acknowledged a lack of energy, lack of interest in his usual activities, social withdrawal, loss of appetite, and hypersomnia. His symptoms improved after seeing a social worker and a further increase in his dose of venlafaxine XR to 150 mg/d. Mr S wondered whether he could discontinue his antidepressant medication.

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