Available Antidepresssant Antidepressant for elderly efficacy for psychotherapy, Antideprexsant, and ECT Electrolyte Drink Nutrition for runners treatment of depression among older adults. Mean age, study duration, percentage elderlly woman, severity of illness at baseline, Antidepressant for elderly of antidepressants in fluoxetine equivalents, year of publication, setting in- or out-patientsantidepressant groups SSRI, TCA, SSNRI, α2-antagonist, SNRI, MAO-inhibitorITT intention-to-treat analysis vs completer analysis, sponsorship and overall risk of bias were not significant moderators of response. Blazer D, Williams CD. There are no specific recommendations for monitoring liver functions in patients on nefazodone.

Antidepressant for elderly -

Treatment of depression. In: Schatzberg AF, Nemeroff CB, eds. The American Psychiatric Press textbook of psychopharmacology.

Treatment of depression in special populations. Block M, Gelenberg AJ, Malone DA. Rational use of the newer antidepressants. Patient Care.

Bhatia SC, Bhatia SK. Major depression: selecting safe and effective treatment. Am Fam Physician. Sporer KA. The serotonin syndrome. Implicated drugs, pathophysiology and management.

Drug Saf. Revicki DA, Brown RE, Palmer W, Bakish D, Rosser WW, Anton SF, et al. Modelling the cost effectiveness of antidepressant treatment in primary care. Nierenberg AA, McColl RD.

Management options for refractory depression. Reynolds CF , Frank E, Dew MA, Houck PR, Miller M, Mazumdar S, et al. Am J Geriatr Psychiatry. Reynolds CF, Frank E, Perel JM, Imber SD, Cornes C, Miller MD, et al.

Nortriptyline and interpersonal therapy as maintenance therapies for recurrent major depression. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.

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The yes-or-no questionnaire is administered orally, and one point is scored for each answer in parentheses. A score of 10 or more indicates depression 84 percent sensitivity; 95 percent specificity. yes Do you feel that your life is empty? yes Do you often get bored?

yes Are you hopeful about the future? no Are you bothered by thoughts that you just cannot get out of your head? yes Are you in good spirits most of the time? no Are you afraid something bad is going to happen to you? yes Do you feel happy most of the time?

no Do you often feel helpless? yes Do you often feel restless and fidgety? yes Do you prefer to stay home at night, rather than go out and do new things? yes Do you frequently worry about the future? yes Do you feel that you have more problems with memory than most?

yes Do you think it is wonderful to be alive now? no Do you often feel downhearted and blue? yes Do you feel pretty worthless the way you are now?

yes Do you worry a lot about the past? yes Do you find life very exciting? no Is it hard for you to get started on new projects?

yes Do you feel full of energy? no Do you feel that your situation is hopeless? yes Do you think that most persons are better off than you are?

yes Do you frequently get upset over little things? yes Do you frequently feel like crying? yes Do you have trouble concentrating? yes Do you enjoy getting up in the morning? no Do you prefer to avoid social gatherings? yes Is it easy for you to make decisions?

no Is your mind as clear as it used to be? Onset of memory loss occurs before mood change. Selective Serotonin Reuptake Inhibitors. Tricyclic Antidepressants. Monoamine Oxidase Inhibitors. Other Antidepressants.

Therapeutic Response. Montvale, N. Duration of Therapy. Barriers to Diagnosis and Treatment. RICHARD B. BIRRER, M. Birrer received his medical degree from Cornell University Joan and Sanford I. Weill Medical College, New York, and completed a family practice residency at State University of New York Health Science Center at Brooklyn.

He has a certificate of added qualification in geriatrics. VEMURI, M. She received her medical degree from Osmania University Gandhi Medical College, Hyderabad, India, and completed a residency in family practice at St.

Birrer, M. Meyers BS. Geriatric psychotic depression. Clin Ger. Continue Reading. More in AFP. Although initial doses of SSRIs should be lower in older people, maintenance doses may be similar to those used in younger people. Fluoxetine has a long half life and can take three to four weeks to reach steady state which can complicate dose titration.

Paroxetine and citalopram have shorter half lives but withdrawal reactions are a disadvantage which requires tapering on discontinuation. Citalopram would be a suitable choice because it has less potential for interactions, which may be a particular concern in elderly people already on complex regimens.

It is important to trial any antidepressant for four to six weeks after reaching the recommended dose, before it is determined ineffective and another drug is tried. Tricyclic antidepressants may be considered in those who do not respond or who are not tolerant of SSRIs.

Again initial doses should be low and increased gradually. TCAs may be more appropriate initially if a concurrent medical condition exists such as urinary incontinence, where a TCA may be substituted for oxybutynin. Nortriptyline is a suitable choice of TCA because it has less sedative and anticholinergic effects, and may cause less orthostatic hypotension.

It is safer to use in elderly people than other TCAs, such as amitriptyline, dothiepin or doxepin. Common - nausea, vomiting, diarrhoea, dizziness, drowsiness, insomnia, agitation, and anxiety. Often these can be prominent in the initial phase of treatment but may improve with time.

Increased risk of falls. Uncommon - hyponatraemia. Symptoms are usually non-specific and include anorexia, nausea, fatigue, lethargy, and confusion. If patients develop any of these symptoms hyponatraemia should be considered and electrolyte levels should be measured.

Common - Anticholinergic side effects which include dry mouth, blurred vision, urinary retention, constipation, and sedation. Increased risk of falls and associated fractures in elderly people. Uncommon - cardiotoxicity. This is an important consideration in elderly people with co-morbid cardiac disease.

Fluoxetine and paroxetine inhibit the hepatic cytochrome P isoenzymes and interact with other drugs metabolised by these enzymes such as TCAs. SSRIs may increase the risk of bleeding and the risk may be further increased by concurrent use of other medicines that increase bleeding risk such as warfarin, NSAIDs or aspirin.

The reversible monoamine oxidase inhibitor MAOI , moclobemide, can be used but there is limited evidence of its efficacy in elderly people. Irreversible MAOIs should only be considered in those who have had a previous good response to them or who are intolerant of other agents.

They have many interactions, including food interactions, making them difficult to use safely. Elderly people with treatment resistant depression can use venlafaxine but special consideration should be given to the potential for adverse cardiovascular effects see BPJ 1 - Venlafaxine.

Depression with a mental or physical co-morbidity is common in elderly people and is likely to respond to antidepressant treatment. Prescribers may have concerns about interaction of the treatment with the co-morbid condition.

Depression is a significant risk factor for falls and falls predispose development of depression. Drug treatment for depression is also an independent risk factor for falls, SSRIs are no safer than TCAs.

The exact reason for this close association between falls and depression is not known. Whether depression results in decreased activity, deconditioning and physical frailty and subsequent falls, or whether there is a central mechanism associated with depression that causes falls, is not known.

Some people with depression have an abnormal gait pattern. Psychological therapy should be considered in all elderly patients with depression. Psychological and pharmacological therapies initiated together are ideal for moderate depression although either treatment alone may be considered in mild depression.

Some suitable psychological therapies for elderly people with depression are; cognitive therapy, supportive psychotherapy, problem-solving therapy and interpersonal therapy.

Electroconvulsive therapy can also be used in severe, unresponsive depression although there are risks associated and antidepressant therapy is usually required to maintain remission.

Exercise benefits people with depression and several trials have had promising results as long as the "dose" and intensity of the activity is adequate.

Attention to compliance is important for people with depression and the successful trial interventions were intensive and supervised. A review of complementary therapies for depression shows St Johns Wort, QiGong, and massage have some evidence of benefit.

It is important to take into consideration potential adverse effects and interactions with conventional treatments. Elderly people with depression are often struggling to cope with the activities of daily living and co-morbidities or major life events may add to the problem.

Social, environmental and household support is often just as important as pharmacological and psychological therapies in helping elderly people with depression.

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Dilemmas: Depression in elderly people Depression in elderly people can be a significant cause of disability and is under-recognised and often complex to treat. In this article Depression is common in elderly people Diagnosis of depression Pharmacological treatments Non-pharmacological treatment options References In this article.

DECISION TO PRESCRIBE Have I identified the cause of the depression? Treat any underlying causes as well as the depression. What am I trying to achieve? Relieve depression. Improve quality of life and functional ability. Is this what the patient wants?

Some elderly people perceive a low mood as normal and will not seek help. Discussion with the patient may help achieve appropriate management. Is there evidence that drugs help achieve this?

RELATED: SSRIs vs. SSRIs are prescribed to both age groups. They are used widely, and considered safe for most people. Dosages are not only determined by age. Symptoms, reaction, weight, and other factors play a role in prescribing antidepressants. Skip to main content Search for a topic or drug.

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How old is too old? There are special considerations for depression in children and seniors. By Donna Christiano Updated on May 20, Medically reviewed by Gerardo Sison, Pharm. Share on Facebook Facebook Logo Share on Twitter Twitter Logo Share on LinkedIn LinkedIn Logo Copy URL to clipboard Share Icon URL copied to clipboard.

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Antidepressant for elderly Psychiatry Antidepressant for elderly 20Nutrition for runners Antidepresswnt Cite this article. Metrics Antidepresaant. Depression is one of the Nutrition for runners causes of the Antidepressznt burden of disease, and it has particularly negative consequences for elderly patients. Antidepressants are the most frequently used treatment. We present the first single-group meta-analysis examining: 1 the response rates of elderly patients to antidepressants, and 2 the determinants of antidepressants response in this population. We extracted response rates from studies and imputed the missing ones with a validated method. Data were pooled in a single-group meta-analysis. Antodepressant us FAQ Contact us Terms Antidepresssant use. Interactive quizzes are based on material found in Best Antidepressant for elderly Journal and Plant-based diet recipes Tests. Fro, quizzes are posted out with journals eleerly Antidepressant for elderly are invited to submit their answers for CME credits. Register or Log in to take part in quizzes. Don't have an account? Register to use all the features of this website, including selecting clinical areas of interest, taking part in quizzes and much more. This item is 16 years and 0 month old; some content may no longer be current.