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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.
For a list of commonly used antidepressants and associated doses for older adults, see the accompanying Table. The selective serotonin reuptake inhibitors (SSRIs) and the newer antidepressants buproprion, mirtazapine, moclobemide, and venlafaxine (a selective norepinephrine reuptake inhibitor or SNRI) are all relatively safe in the elderly.
Medicine options to treat depression include SSRIs, SNRIs, atypical antidepressants, tricyclic antidepressants, MAOIs and other drugs.
In evaluating adverse outcomes among older adults initiating antidepressants, sertraline is the best choice for benefits, side effects, and safety.
Best Antidepressants for Preventing Depression Relapse & Maintenance Treatment (Study) Analyzing Cardiovascular Effects & Risks of Newer Antidepressants; Long-Term Antidepressant (SSRI) Use Increasing: Overprescription & Withdrawal Hesitancy
Concordant with American Psychiatric Association guidelines, expert consensus guidelines for older adults propose that optimal treatment consists of antidepressant medication coupled with psychotherapy .
A large comparative effectiveness study is currently underway that seeks to address this evidence gap: “Optimizing outcomes in older adults with treatment-resistant depression” (OPTIMUM) will compare common antidepressant approaches for depression in older adults.
An expert consensus guideline indicates that, for minor depressive episodes among older adults, appropriate first-line treatments include an antidepressant alone, psychotherapy alone, or the combination of an antidepressant with psychotherapy. 13 The combination of an antidepressant with psychotherapy is the most widely recommended first-line ...
For specific patients, a PIM mentioned in the Beers Criteria may be the best treatment option. As all antidepressants are represented within at least one Beers Criteria section, it is important to understand why these agents are considered PIMs and how to use them in the safest manner possible.
A meta-analysis indicates which antidepressants are most effective, and which are most likely to cause dizziness.