Tricyclic antidepressants, especially amitriptyline and dothiepin,¹⁶ are known to pose a high risk of death in overdosage. These drugs should therefore be avoided in older people whose medication is not supervised and who are at risk of taking an overdose.

What drugs should be avoided in geriatric patients?

AVOID Certain Anticholinergic Drugs

• Antidepressants amitriptyline (Elavil) and imipramine (Tofranil)
• Anti-Parkinson drug trihexyphenidyl (Artane)
• Irritable bowel syndrome drug dicyclomine (Bentyl)

Which antidepressant class is safest to try in an older patient?

SSRIs considered to have the best safety profile in the elderly are citalopram, escitalopram, and sertraline. [16] These have the lowest potential for drug-drug interactions based on their cytochrome P-450 interactions.

Which class of drugs is usually the first line choice for treating depression in older adults?

Usually, SSRIs are considered as the first line treatment of choice. Among the various SSRIs, escitalopram and sertraline are considered to have minimal drug interactions and are considered to be safe in presence of wide range of physical illnesses.

Are antidepressants bad for the elderly?

Studies have found that while antidepressants can be helpful in older adults, they may not always be as effective as in younger patients. Also, the risk of side effects or potential reactions with other medicines must be carefully considered.

What is the most common inappropriately prescribed drug to the elderly?

Diphenhydramine and amitriptiline are the most common inappropriately prescribed medications with high risk adverse events while propoxyphene and doxazoxin are the most commonly prescribed medications with low risk adverse events.

Which drug is more likely to be potentially inappropriate for older adults?

In one study, 19 percent of 2508 community-dwelling older adults were using one or more medications inappropriately; NSAIDs and benzodiazepines were the drug classes with the most potential problems [43].

Why is Paxil not recommended for seniors?

Paroxetine has strong anticholinergic and sedative properties, which can lead to negative effects on cognition. Anticholinergic medications such as paroxetine are often considered potentially inappropriate for the elderly patients with dementia and cognitive impairment.

Is Paxil safe for the elderly?

However, elderly patients may be more sensitive to the effects of this medicine than younger adults, and are more likely to have hyponatremia (low sodium in the blood), which may require caution and an adjustment in the dose for patients receiving paroxetine.

Is Remeron safe for elderly?

Mirtazapine is clearly better tolerated than tricyclic agents and is appropriate for some geriatric patients. Mirtazapine may be especially helpful in those who need a sedating agent or in patients who need to gain weight. An increase in appetite was reported in 17 percent of patients taking mirtazapine.

When is the use of antidepressant therapy appropriate in an elderly patient?

Depressive illness in later life should be treated with antidepressants that are appropriate for use in geriatric patients. A comprehensive, multidisciplinary approach, including consideration of electroconvulsive treatment in some cases, is important.

What medication class is considered first line in a patient who has major depressive disorder?

SSRIs, which include fluoxetine, sertraline, paroxetine, citalopram, escitalopram, and fluvoxamine, have become the first-line treatment for major depression.

What is the best antidepressant for dementia patients?

Antidepressants such as sertraline, citalopram, mirtazapine and trazodone are widely prescribed for people with dementia who develop changes in mood and behaviour. There is some evidence that they may help to reduce agitation – particularly citalopram.

Is Zoloft recommended for the elderly?

Sertraline is a selective serotonin reuptake inhibitor (SSRI) with well established antidepressant and anxiolytic activity. Results from several well designed trials show that sertraline (50-200 mg/day) is effective in the treatment of major depressive disorder in elderly patients (> or =60 years of age).

What is the best anti anxiety medication for elderly?

Buspirone is an anti-anxiety drug that has been shown to be effective for older adults. Benzodiazepines, another anti-anxiety drug, are effective but should be prescribed carefully to older adults because of risk of memory impairment, unsteadiness, and falls.

Is Wellbutrin Safe for Elderly?

PARIS, FRANCE — September 20, 2006 — Once-daily use of an extended-release formulation of bupropion (Wellbutrin XL(R)) is both efficacious and safe in elderly patients with major depressive disorder, according to a multicentre, randomised, double-blind, flexible-dose, placebo-controlled trial.