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[Comment] Management of late-life depression: a major leap forward

Research over the past 20 years has provided robust evidence for the efficacy of antidepressants in the acute phase of late-life major depression1 and, once people are well, for their use in the continuation and maintenance phases.2 But what do we do when patients do not get well during the acute treatment phase? This problem of treatment-resistant late-life depression, occurring in 50–66% of patients depending upon its definition, is a major issue faced by psychiatrists treating people with depression aged older than 60 years.