Tricyclic antidepressants have manyknow contraindications such as dementia, cardiac conductive abnormalities, chronic constipation, prostatism or history of urinary retention [7]. So, tricyclic antidepressants should be avoided for being highly anticholinergic, sedating and causing orthostatic hypotension [8].
SSRIs considered to have the best safety profile in the elderly are citalopram, escitalopram, and sertraline.
Benzodiazepines and beta blockers should generally be avoided when treating anxiety in the elderly. There is not enough evidence to support the use of antipsychotics or mood stabilizers given their risk of problems in both the long and short term.
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).
Conclusion: Sertraline is an effective and well tolerated antidepressant for the treatment of major depressive disorder in patients aged > or =60 years.
In general, SSRIs are considered the most well-tolerated antidepressants, per the Mayo Clinic; they typically have fewer side effects than other types and can be safely used at higher doses. Common side effects of SSRIs include sexual dysfunction, weight gain, trouble sleeping, drowsiness, dizziness, and nausea.
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].
Hospitalization rates due to adverse drug effects are 4 times higher in older patients (about 17%) than in younger patients (4%). And 66% of these hospitalizations in older patients are due to 4 drugs or drug classes—warfarin, insulin, oral antiplatelet drugs, and oral hypoglycemic drugs.
For patients with diabetes, dyslipidemia, or obesity, the experts would avoid clozapine, olanzapine, and conventional antipsychotics (especially low- and mid-potency).
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.
In this clinical trial of SSRI treatment for GAD in older adults, we found that escitalopram was better than placebo in terms of cumulative response and improvements in anxiety symptoms and self-reported role functioning.
The most common anxiety disorder among older adults, generalized anxiety disorder (GAD), is excessive, long-lasting worry about many things.
Antidepressants such as sertraline, citalopram, mirtazapine and trazodone are widely prescribed for people with dementia who develop changes in mood and behaviour. There is some evidence that they may help to reduce agitation – particularly citalopram.
In the study, Lenze and colleagues evaluated 177 people aged 60 or older with generalized anxiety disorder who got either Lexapro or a dummy pill for 12 weeks. They found 69 percent of patients got better, compared with 51 percent of those whose symptoms improved simply by taking a placebo.
Exercise. Research suggests that regular exercise may be a more effective treatment for mild depression than antidepressants. Exercise helps boost levels of chemicals called serotonin and dopamine in the brain, which can lift your mood.
Health experts flag these types of medications as increasing falls risk: Psychoactive medications, including anticonvulsants, antidepressants, antipsychotics, benzodiazepines, opioids, and sedatives/hypnotics. Prescription and over-the-counter antihistamines. Muscle relaxants.
Oxycodone, hydrocodone, and other opioid painkillers increase the risk for falls. Because of their many side effects, pain medications should always be used carefully—at the lowest effective dose and for as short of a time as possible.
A potentially inappropriate medication (PIM) is one prescribed without indication or where the net clinical benefit does not outweigh the risk. PIM use is a common cause of adverse drug reactions in older adults [1,2].
Three types of drugs are abused most often: • Opioids—prescribed for pain relief • CNS depressants—barbiturates and benzodiazepines prescribed for anxiety or sleep problems (often referred to as sedatives or tranquilizers) • Stimulants—prescribed for attention-deficit hyperactivity disorder (ADHD), the sleep disorder ...
What are the most common antidepressants? Sertraline hydrochloride, used for multiple mental health and mood disorders, is the most prescribed antidepressant on the list with more than 18 million prescriptions in 2021.
Selective serotonin reuptake inhibitors (SSRIs).
These antidepressants generally cause fewer bothersome side effects and are less likely to cause problems at higher therapeutic doses than other types of antidepressants.