SSRIs considered to have the best safety profile in the elderly are citalopram, escitalopram, and sertraline.
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.
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.
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.
Conclusions. Based on these results, we conclude that clinicians can expect that about 50.7% of elderly patients with major depressive disorder treated with antidepressants experience an improvement in symptoms. This response rate is not substantially different from the one in the general adult population.
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.
Psychotherapy, counseling, or “talk therapy” that can help a person identify and change troubling emotions, thoughts, and behavior. It may be done with a psychologist, licensed clinical social worker (LCSW), psychiatrist, or other licensed mental health care professional.
Benzodiazepines (also known as tranquilizers) are the most widely prescribed type of medication for anxiety. Drugs such as Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), and Ativan (lorazepam) work quickly, typically bringing relief within 30 minutes to an hour.
Some common risk factors for anxiety disorders in seniors include: Stressful life events (e.g., death of a loved one) Limited physical mobility. Loss of independence.
Sertraline (Zoloft) and venlafaxine (Effexor) are equally useful for treating panic disorder with or without agoraphobia. They are also overall the most well-tolerated medications for the treatment of panic disorder.
Selective serotonin reuptake inhibitors (SSRIs).
Health care providers often start by prescribing an SSRI . These antidepressants generally cause fewer bothersome side effects and are less likely to cause problems at higher therapeutic doses than other types of antidepressants.
The first-line medicine for patients with depression is generally a SSRI, e.g. citalopram, escitalopram, sertraline or fluoxetine (Tables 1 and 2).
Many doctors start by prescribing a type of drug called a selective serotonin reuptake inhibitor (SSRI), such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil) or sertraline (Zoloft).
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].
Drugs Older Adults Should Use with Caution
Also, consider avoiding aspirin, ibuprofen, and naproxen entirely if you're older than 75, taking an oral steroid, or taking a prescription blood thinner. Heart failure or irregular heartbeat medication: digoxin (Lanoxin).
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.
Anxiety becomes more common with older age and is most common among middle-aged adults. This may be due to a number of factors, including changes in the brain and nervous system as we age, and being more likely to experience stressful life events that can trigger anxiety.
The Significance of Depression Depression, a type of mood disorder, is the most prevalent mental health problem among older adults.
The most common anxiety disorder among older adults, generalized anxiety disorder (GAD), is excessive, long-lasting worry about many things.
Antidepressants are the first-line treatment in anxiety disorders [16]. The selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) are more commonly used in the elderly, due to their tolerability and safety profile in this population [17].
The selective serotonin reuptake inhibitors (SSRIs) are probably the treatment of choice in treating depression and a gamut of comorbid anxiety disorders. The most used SSRI is escitalopram.
Buspar® (Buspirone)
This non-addictive anxiety medication is similar to an SSRI in that it increases chemical messengers involving serotonin. Buspar only targets one subtype of the serotonin receptor, so it affects just one specific area of your brain.
Depression is a mental health condition that can affect people of any age. More than 1 in 10 older people experience depression. The 3 main causes of depression in older people are poor physical health, social isolation and loss.
Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional.
And depression treatment is found to work just as well in seniors as it does in younger populations. If you think you may have depression, start by making an appointment with your health care provider. Your provider can first rule out other culprits that may be causing your symptoms.