#115 Geriatric Depression

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.8 • 3.1K Ratings

🗓️ 24 September 2018

⏱️ 46 minutes

🔗️ Recording | iTunes | RSS

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Summary

Geriatric depression got you down? Boost your spirits with tips and tactics from Geriatric Psychiatrist, Dennis Popeo MD, Clinical Associate Professor of Psychiatry at NYU Langone Medical Center. Topics include: suicide in the older adults; how to diagnosis depression in older adults; how to counsel patients about antidepressants, how to choose an antidepressant, how to monitor and titrate medications, and how long to continue therapy. Stay tuned for part two of our discussion with Dr Popeo on managing sleep and behavioral problems in older adult patients with dementia.

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Credits

Written & Produced by: Jordana Kozupsky NP, Matthew Watto MD

Artwork by: Kate Grant MD

Hosts: Jordana Kozupsky NP, Matthew Watto MD

Editor: Matthew Watto MD

Guest: Dennis Popeo, MD

Time Stamps

00:00 A question for you, the listeners
01:12 Disclaimer, intro and guest bio
05:00 Getting to know our guest, recommendations for reading, and career advice
14:13 Case of geriatric depression; effective history taking; recognizing associated symptoms; depression scales
19:03 Suicide in older adults; firearm safety
24:26 Choice of therapy; Pharmacologic agents; Counseling patients and managing expectations; Dose titration and tracking symptoms
34:41 Augmenting therapy versus cross-titration to another agent; When is it okay to stop an antidepressant
40:50 Take home points
44:40 Outro

Tags: psychiatry, psych, geri, geriatrics, depression, mdd, sleep, insomnia, appetite, agitation, suicide, SSRIs, side, effects, therapy, diagnosis, serotonin, mirtazapine, bupropion, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Transcript

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0:00.0	Hey everyone, this is Matt with The Curb Siders and before we get into the show tonight,
0:04.1	I wanted to ask your favor. If you would send us a little bit of feedback,
0:07.7	a lot of our episodes, we have these great long discussions with our specialists and at the end,
0:13.6	we have these episodes that may be anywhere from 60 to 90 minutes long. I struggle with whether
0:19.1	to split these into two episodes or keep them just as one longer episode. So I'd love to know
0:24.0	your thoughts on that. For this episode, I decided to go ahead and split our talk with Dr. Popeo
0:29.1	into two separate episodes, which I think happens nicely. The first part, we talk all about
0:34.5	dementia in the elderly. Specifically, we talk about suicide. We talk about how to choose between
0:40.5	medications. We talk about how to titrate medications when you can start and stop them in some of
0:45.6	the adjuvant therapies on part two, which will come out a bit later. We will be talking about
0:51.7	sleep problems in older adults as well as how to treat behavior issues in dementia. Specifically,
0:58.8	we talk about benzodiazepines and anti-psychotic agents, which I know are controversial. So I think
1:05.1	you'll find it very interesting. So without further ado, let's get to our part one with Dr. Popeo.
1:29.7	Welcome back to the curbsiders. And I am without my normal co-host tonight. Stuart and Paul
1:54.5	have are both actually having late nights in the hospital. And with me tonight is Jordana Kuzupski.
2:01.6	And we'll just be calling you Jordy for the show. Hey, Jordy, thank you for coming on again.
2:06.7	That's easier. Thank you for having me. So what? So you got married since the last show. You were on
2:12.0	you were on the show with Dr. John Ryan on pulmonary hypertension, which was a very popular show.
2:17.1	And this one for this one, you got as a great guest. Found us a great guest from New York.
2:23.1	Right. He's sort of a neighbor of mine, I guess, in a different borough. And yeah, I got married.
2:28.4	I started a new job. I'm now a palliative care nurse practitioner. So this episode will be
2:33.8	particularly applicable to my population. So I did this a little bit selfishly.
	...

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