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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.
Depression in the elderly is a significant, common, and growing problem that requires treatment. It has serious implications for the patient, family, and community. Identification followed by a thorough assessment can help guide the selection of an appropriate antidepressant medication.
Elderly people are generally more susceptible to anticholinergic effects, and the newer antidepressants should therefore be preferred. If a tricyclic antidepressant has to be used, drugs with pronounced anticholinergic effects, such as amitriptyline, should be avoided.
5 Sep 2019 · Current NICE guidance recommends prescribing antidepressants for older people at an age‐appropriate dose, taking into account the effect of general physical health and concomitant medication, and to carefully monitor for side effects . The risk of antidepressants can be minimised by starting at a low dose and slowly titrating upward.
2 Ogo 2011 · 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. 1 However, given the likelihood of poor functional outcomes and the increased risk of premature death by suicide, vascular disease, accident, or ...
Response to antidepressants in the elderly varies widely from 45% to 80%, compared with 35% to 70% for placebo, with inconsistencies in part owing to use of secondary analysis, variable age cutoffs, and short trials. Efficacy might decrease with patient age.
But if it doesn't relieve your symptoms or it causes side effects that bother you, you may need to try another. So don't give up. Many kinds of antidepressants are available, and chances are you'll be able to find one that works well for you. And sometimes a combination of medicines may be an option.
