Antidepressants for older adults

What is the best antidepressant for elderly people? What are the top antidepressants? Are statins effective for primary prevention in older adults?

TMS ( Transcranial Magnetic Stimulation ). CBT (Cognitive Behavioral Therapy).

Electroconvulsive Therapy ( ECT ). Second-generation antidepressants (SSRIs, SNRIs or NDRIs) are recommended for older adults due to the reduced risk of side effects and safety in the event of overdose. If considering medication for older adults with depression, the panel recommends combining it with interpersonal psychotherapy. In the study, adults over who took newer generation antidepressants selective serotonin reuptake inhibitors , or SSRIs had a greater risk having a stroke or seizures than those who took older generation antidepressants, or tricyclic antidepressants , TCAs.

Use cognitive behavioral therapy ( CBT ). Consider electroconvulsive therapy ( ECT ). Medical Comorbidity as a Selection Criteria. Orthostatic hypotension ,.

Antidepressants play an important role in the treatment of late-life depression. Concordant with American Psychiatric Association guidelines, expert consensus guidelines for older adults propose that optimal treatment consists of antidepressant medication coupled with psychotherapy. For a list of commonly used antidepressants and associated doses for older adults, see the accompanying Table. The selective serotonin reuptake inhibitors ( SSRIs ) and the newer antidepressants buproprion , mirtazapine , moclobemide , and venlafaxine (a selective norepinephrine reuptake inhibitor or SNRI ) are all relatively safe in the elderly. Study found that SSRIs seemed to have more side effects than older antidepressants.

Please note: This article was published more than one year ago. The facts and conclusions presented may have since changed and may no longer be accurate. And More information links may no longer work. Many effective antidepressants are available that have various potential advantages for the individual patient.

SSRIs have become first-line medications based largely on tolerability, ease of use, and safety profile. Authors and Disclosures. The evidence base for the optimal length of treatment in older adults is uncertain. NICE guidance recommends continuing antidepressant treatment for at least six months following remission. However, NICE also recommends continuing treatment for at least two years in the case of relapse of a recurrent depressive disorder, or if there are risk factors for relapse or the consequences of relapse are likely to be severe.

Some older adults prefer to get counseling or psychotherapy for depression rather than add more medications to those they are already taking for other conditions. Suicidal thoughts or behavior: All antidepressants may increase the risk of suicidal thoughts or behavior in children, adolescents, and young adults (to years of age). Bupropion should not be used in patients with seizure disorders, eating disorders, and within weeks of using MAOIs.

Effexor appeared to be more effective than SSRIs in both older and younger women. SSRIs include fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro). SSRIs can affect the lining of the stomach, so older people are usually advised to take the drugs with food to prevent nausea. An newer antidepressants prescribed for non-specific psychiatric symptoms and unclear diagnoses were overprescribed most often.

The major conclusion of the article — that care should be taken in prescribing and in selecting which antidepressant medication to prescribe for older adults — is unquestionably correct and is nothing new. In older adults , we must be aware of the possibility of profound side effects that are particularly potent to this vulnerable group. This session will highlight the issues surrounding the prescription of antidepressants. 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.

Therefore, adverse event frequencies and expectations may vary when higher doses are used for efficacy purposes. Selection should be based on the best side effect profile and lowest risk of drug-drug interactions.