FAQ: Elderly Patients Who Take Tricyclic Antidepressants?

Tricyclic antidepressants are no longer considered first-line agents for older adults given their potential for side effects, including postural hypotension, which can contribute to falls and fractures, cardiac conduction abnormalities, and anticholinergic effects.

Why is amitriptyline bad for the elderly?

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of amitriptyline in the elderly. However, elderly patients are more likely to have age-related liver problems, which may require an adjustment in the dose for patients receiving amitriptyline.

Why are antidepressants bad for elderly?

One particular concern is that antidepressants increase the risk of falls, osteoporosis and fractures. Falls are a known risk for the older tricyclic antidepressants as they increase the risk of orthostatic hypotension.

What is the most concerning issue with tricyclic antidepressants?

Some tricyclic antidepressants are more likely to cause side effects that affect safety, such as: Disorientation or confusion, particularly in older people when the dosage is too high. Increased or irregular heart rate. More-frequent seizures in people who have seizures.

Who should not take tricyclic antidepressants?

Ask your doctor before taking TCAs if you:

  • Are under age 25 or over age 65.
  • Have diabetes, heart problems, or a thyroid disorder.
  • Have any conditions affecting your urinary tract or an enlarged prostate.
  • Have glaucoma.
  • Have a liver disease.
  • Have a history of seizures.
  • Take medications to help manage your mood.

Why tricyclic antidepressants are not recommended for elderly patients?

Tricyclic antidepressants are no longer considered first-line agents for older adults given their potential for side effects, including postural hypotension, which can contribute to falls and fractures, cardiac conduction abnormalities, and anticholinergic effects.

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Which antidepressant should be avoided in the elderly?

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.

Is it safe for the elderly to take antidepressants?

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 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)

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.

Which of the following side effects are associated with the use of tricyclic antidepressants?

Tricyclic antidepressants may cause:

  • blurred vision,
  • dry mouth,
  • constipation,
  • weight gain or loss,
  • low blood pressure on standing,
  • rash,
  • hives, and.
  • increased heart rate.

What is the difference between SNRI and tricyclic antidepressants?

An SNRI does the same thing for another important chemical, noradrenaline, as well as serotonin. Tricyclic antidepressants do a similar thing but are less selective in their activity.

Are tricyclic antidepressants safe?

When taken at the recommended dosage, tricyclic antidepressants are considered safe. However, they have been associated with a few severe side effects, some potentially fatal, such as: An increase in suicidal thoughts and behaviors, particularly in children and young adults under the age of 25 years.

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Do tricyclic antidepressants cause dementia?

Treatment with tricyclic antidepressants was associated with a reduced risk of dementia, whereas treatment with SSRIs, MAOIs, heterocyclic antidepressants, and other antidepressants was associated with an increased risk of dementia.

Is there an alternative to amitriptyline?

If side effects are a problem, there are other similar drugs (for example, nortriptyline, imipramine, and now duloxetine) that are worth trying as they are nearly as effective, and often have less side effects,.

Does Elavil affect blood pressure?

Elavil can cause severe high blood pressure when used with epinephrine.

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