title: Safety of antidepressants in the elderly.
abstract: Until the 1980s, the two major classes of antidepressants, the tricyclics and the monoamine oxidase inhibitors (MAOIs), were effective but had severe side effects, requiring monitoring by psychiatrists. The past several years have brought new classes of antidepressants that are safer for the patient to take and far easier for the non-psychiatrist to prescribe. Whilst this is of enormous value, it leaves the physician with the dilemma of which one to prescribe. These new antidepressants cannot safely be used interchangeably. This paper will discuss each of the antidepressants presently available, with particular emphasis on safety in the elderly. Drug interactions, side effects and particular challenges to the older patient will be described. The authors will then advise a general strategy for prescribing antidepressants.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305-5723, USA. brsommer@stanford.edu
authors.forename: Barbara R
authors.initials: BR
authors.lastname: Sommer
authors.forename: Howard
authors.initials: H
authors.lastname: Fenn
authors.forename: Peter
authors.initials: P
authors.lastname: Pompei
authors.forename: Charles
authors.initials: C
authors.lastname: DeBattista
authors.forename: Anna
authors.initials: A
authors.lastname: Lembke
authors.forename: Po
authors.initials: P
authors.lastname: Wang
authors.forename: Ben
authors.initials: B
authors.lastname: Flores
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D003577:Cytochrome P-450 Enzyme System / Q000502:physiology; D003866:Depressive Disorder / Q000188:drug therapy / Q000378:metabolism; D004347:Drug Interactions; D006801:Humans; D008996:Monoamine Oxidase Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000928:Antidepressive Agents; D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D003577:Cytochrome P-450 Enzyme System; D008996:Monoamine Oxidase Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors