2 Conclusions on the effectiveness of treatments for latelife
depression
Treatment
Evidence
level* Conclusion
Medical treatments
Antidepressant
medication
I Sound evidence of effectiveness
Electroconvulsive
therapy
I Sound evidence of effectiveness,
but only appropriate in extreme
circumstances
Oestrogen II No effect found
Testosterone III-3 No convincing evidence
Transcranial
magnetic stimulation
II No convincing evidence
Psychological treatments
Cognitive behaviour
therapy
I Sound evidence of effectiveness,
but not for stroke patients
Dialectical behaviour
therapy
II Evidence of effectiveness as adjunct
to antidepressant medication
Interpersonal
therapy
II Some evidence of effectiveness
Problem-solving
therapy
II Some evidence of effectiveness
Psychodynamic
psychotherapy
II Sound evidence of effectiveness
Reminiscence and
life review
I Sound evidence of effectiveness
Bibliotherapy II Sound evidence of effectiveness for
mild to moderate depression
Lifestyle changes and alternative therapies
Alcohol avoidance V No evidence
Exercise II Evidence of effectiveness
Fish oils V No convincing evidence
Light therapy II Evidence of effectiveness for people
in hospitals or nursing homes
Massage therapy III-3 No convincing evidence
Music therapy V No evidence
St John’s wort II Evidence of effectiveness for mild to
moderate depression
Vitamins
Folate II Some evidence of effectiveness for
patients with Alzheimer’s disease
III-3 No convincing evidence for patients
without Alzheimer’s disease
Other B vitamins II No convincing evidence
Vitamins C, D and E V No evidence
* Based on National Health and Medical Research Council levels of
evidence,12 with the addition of “Level V” for even weaker types of evidence