Anti depressant is always a drug in an elderly patient’s prescription. Read on to know which one is the safest.

Team@ CMHF

Tricyclics may be the safest choice for older patients who need an antidepressant, researchers found.

Compared with tricyclics, selective serotonin reuptake inhibitors (SSRIs) and “other” antidepressants conferred a higher risk of all-cause mortality, stroke or transient ischemic attack, falls, fractures, epilepsy or seizures, and hyponatremia
They noted, however, that even in an analysis stratified by dose, tricyclics tended to carry a lower risk of several negative outcomes in each category.

During an average follow-up of five years, 89% of the patients received at least one prescription for an antidepressant.
Of nearly 1.4 million antidepressant prescriptions, 54.7% were for SSRIs, 31.6% were for tricyclics, and 13.5% were for other antidepressants. The median duration of use was about one year.

All of the antidepressant classes were associated with elevated risks of all-cause mortality, attempted suicide or self-harm, falls, fractures, and upper GI bleeding compared with no antidepressant use.

“Older people therefore require careful monitoring for adverse effects, with provision of information (to the patient and [caregiver]) about the risks of falls, confusion, agitation, and increased suicidal ideation,” he wrote in an accompanying editorial.

“They should also be advised that adverse effects are most commonly encountered during the first few weeks of treatment. For this reason, patients should be monitored at least weekly during the first month of treatment and again when drugs are stopped,” Hickie wrote

Ref: http://www.medpagetoday.com/Geriatrics/Depression/27869?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&userid=333280