Geriatric antidepressants

What are the top antidepressants? Is Prozac the most prescribed antidepressant? How are tricyclic antidepressants used to treat ADHD? Is mirtazapine considered a good antidepressant? When selecting an antidepressant it is important to consider the elderly pa­tient’s previous response to treatment, the type of depression, the patient’s other medical problems, the patient’s other medications, and the potential risk of overdose.

Psychotic depression will likely not respond to antidepressant monotherapy, while bipolar depression will require a mood stabilizer.

Tricyclic antidepressants : If an elderly individual is using a tricyclic antidepressant , they need to be used with precaution due to their side effects. Various tricyclics that appear to be effective for old people include: nortriptyline , amitriptyline , clomipramine, and desipramine. Clinical data from depression studies in the elderly can guide effective antidepressant treatment and monitoring to reduce morbidity and mortality from both the depressive disorder and from adverse reactions to the medication.

Such data are anticipate for example,. SSRI’s are the class of choice for initial antidepressant therapy. However, it has some anticholinergic effects that make it not so desirable for use in the elderly.

Another SSRI that makes the naughty list in the elderly is fluvoxamine. The study, published in the Journal of the American Geriatric Society, examined how treating Major Depressive Disorder (MDD) in adults over with certain classes of antidepressants can lead to adverse effects.

The newer SSRIs are effective and generally well tolerated by elderly patients. These drugs have largely supplanted the tricyclic antidepressants (TCAs) as first-line agents due to their comparative cardiac safety, ease of use, tolerability, minimal anticholinergic effects, and low lethality in overdose. Using data from a prospective cohort study,. The side effects and potential for drug interactions are considered too high to be safe in most cases for elderly patients. March Elderly patients who stay on antidepressant drugs after recovering from depression are much less likely to suffer recurrences than patients taken off the drugs or those treated with psychotherapy alone, an important new study suggests.

To discuss pharmacologic treatment of depression in the elderly, including choice of antidepressants , titration of dose, monitoring of response and side effects, and treatment of unresponsive cases. Popeo finds mirtazapine useful for patients with poor appetite and poor sleep. Bupropion can be stimulating, but be careful in patients who are underweight (it decreases appetite), anxious (it worsens anxiety),.

The Guide was prepared by Highmark Inc. The information presented above has been compiled from available medical literature and is intended to serve only as reference. Prolonged antidepressant treatment and the combination of donepezil with antidepressants may improve cognitive performance and reduce the risk of progression to dementia in older adults. Despite the evidence suggesting the benefits of antidepressant maintenance treatment for older adults, there are still several open questions that have not been addressed. Practical advantages include their ease of use, safety in overdose, and tolerability.

They are not devoid of side effects, but these are similar throughout the class and include fatigue, nausea, sleep disturbances, sexual dysfunction, and weight gain. Several antidepressants are efficacious in elderly patients with a major depressive episode without psychotic features. Selection should be based on the best side effect profile and lowest risk of drug-drug interactions. Geriatric depression: The use of antidepressants in the elderly ulations, and when mixed-aged groups have been studied older adults have been underrepresented.

This limits the ability to generalize from these study findings when treating the elderly.

Food and Drug Administration (FDA) for the treatment of major depressive disorder (MDD) in adults. Remeron works by increasing the production of serotonin and norepinephrine, two neurotransmitters that are known to influence moods and cognition. Response to antidepressants in the elderly varies widely from to , compared with to for placebo, with inconsistencies in part owing to use of secondary analysis, variable age cutoffs, and short trials. Efficacy might decrease with patient age.

TCAs) are equally effective in the elderly, SSRIs tend to be better tolerated and associated with fewer adverse effects. Women with severe depression and with a prior history of depression can be treated with a combination of antidepressant medication and psychotherapy. Careful monitoring is needed for adverse effects, particularly in the first month of treatment Because older people with clinical depression have high rates of concurrent medical illness, particularly cerebrovascular disease, they are at high risk of adverse events from most antidepressants. BMJ finds that an older group of drugs known as tricyclic antidepressants may sometimes be safer in people over the age of 65.

Still, several factors need to be considered when choosing an antidepressant, possible side effects being just one of them. As with most medications, many people experience some side effects, which in most cases can be managed or minimized. Most side effects lessen over time.

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