FAQ: 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.

What is the safest antidepressant for the elderly?

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.

Is Zoloft safe for elderly?

Sertraline is generally well tolerated in elderly patients with major depressive disorder and lacks the marked anticholinergic effects that characterise the adverse event profiles of tricyclic antidepressants (TCAs).

Why is amitriptyline not recommended for seniors?

Tertiary amine tricyclics such as amitriptyline and imipramine have been reported to be effective in depressed geriatric patients, but because of their potential for side effects, it is not advisable to use them in the elderly.

Are antidepressants bad for 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.

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.

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)
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What is the safest antidepressant?

Among the newer antidepressants, bupropion and venlafaxine were associated with the highest case fatality rates. In addition, among SSRIs, citalopram and fluvoxamine appeared to be related to higher mortality rates in overdose, whereas fluoxetine and sertraline were the safest [188].

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.

Is Cymbalta safe for elderly?

Conclusions: Duloxetine improved cognition, depression, and some pain measures and was safe and well tolerated in elderly patients with recurrent major depressive disorder.

Is citalopram safe for elderly?

March 28, 2012 — The selective serotonin reuptake inhibitor (SSRI) citalopram (Celexa, Forest Laboratories) should not be used at doses greater than 20 mg per day in adults older than 60 years because of a potential risk for QT prolongation, the FDA warns.

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.

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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.

Should antidepressant medication be used in the elderly?

Late-life depression is a serious illness accompanied by medical morbidity, cognitive decline, and risk of suicide. Antidepressant medications are a cornerstone of treatment for depressed elders. Although they are optimally provided in conjunction with psychotherapy, in many cases they are used alone.

What depression medication has the least side effects?

Selective serotonin reuptake inhibitors (SSRIs). These medications generally cause fewer bothersome side effects and are less likely to cause problems at higher therapeutic doses than other types of antidepressants are.

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