background Late-onset depression with vascular brain lesions is showing increased resistance to antidepressive pharmacotherapy.
aim To give an overview of alternative treatment options.
method We conducted a literature search via PubMed using the key words: 'late-onset depression', 'white matter lesions', 'cerebrovascular pathology' and 'treatment' and thereby a search for all available clinical studies about the treatment described in combination with the key words 'vascular depression', or 'late-onset depression' and 'white matter lesions'.
results Electroconvulsive therapy, repetitive transcranial magnetic stimulation and nimodipine augmentation have beneficial effects on vascular depression.
conclusion The treatment options mentioned are promising, but there is a need for further clinical studies.