Conclusion: Sertraline is an effective and well tolerated antidepressant for the treatment of major depressive disorder in patients aged > or =60 years.
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.
Mirtazapine is recommended in the elderly given its safe side effect profile and minimal drug-drug interaction. In addition, side effects can be used to our advantage as mirtazapine can help with insomnia and increase appetite in patient with weight loss.
Two recent reviews of research in this area concluded that discontinuation effects, sexual dysfunction, weight gain, and sleep disturbance (multiple long-wake periods) are adverse effects of long-term SSRI use.
Aside from its ability to improve the symptoms of depression, studies have shown that Zoloft significantly reduces¹ anxiety symptoms. Importantly, this research also showed that Zoloft is still an effective treatment for depression and anxiety regardless of any other psychiatric conditions.
Sertraline is generally well tolerated in elderly patients with major depressive disorder and lacks the marked anticholinergic effects that characterise the adverse event profiles of tricyclic antidepressants (TCAs).
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].
Sertraline, like other antidepressants, may increase the risk of suicidal ideation and behavior in children, adolescents, and young adults with major depression.
Commonly used drugs: Antidepressants often used in older people with dementia include: Selective serotonin reuptake inhibitor (SSRI) antidepressants: Citalopram, escitalopram, and sertraline (brand names Celexa, Lexapro, and Zoloft, respectively) are often used.
Overall, citalopram appears to be the best-tolerated SSRI, followed by fluoxetine, sertraline, paroxetine, and fluvoxamine. The latter 2 drugs are associated with the most side effects and the highest discontinuation rates because of side effects in clinical trials.
One method called cognitive behavioral therapy (CBT) aims to help patients end destructive patterns of behavior and modify their thoughts to be more positive. Interpersonal therapy is another approach that helps patients work to improve their relationships with others and strengthen and expand their support systems.
When it comes to antidepressants for elderly patients, most experts recommend SSRIs or selective norepinephrine reuptake inhibitors (SNRIs), which help increase certain brain chemicals such as serotonin. These drugs tend to have fewer serious side effects and drug interactions than older antidepressants on the market.
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.
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.
Prioritize reassurance, validation, and emotional connection over rational explanations. No matter what their age or mental condition, people respond to feeling heard and loved. And once the brain starts changing, it's even less likely that a logical explanation will relieve a person's anxiety.
Many individuals report that Zoloft helps their anxiety and depression. Selective serotonin reuptake inhibitors such as Zoloft work in your body by preventing the reabsorption of serotonin, and the prevention of this process results in higher levels of serotonin available for use in your brain.
“Your sertraline is working if you feel calmer. Your negative moods or anxiety will not be as intense. You should be enjoying activities more. And your sleeping and eating habits should be more stable,” says Doughty.
They found that sertraline was more effective at reducing anxiety symptoms—such as nervousness, irritability, and restlessness—with improvements showing after six weeks, while it took 12 weeks for modest changes in depressive symptoms—such as low mood—to show.
For people with chronic or severe depression, medication may be needed on a long-term basis. In these cases, antidepressants are often taken indefinitely.
Sertraline can cause permanent memory problems, particularly if taken irregularly, even at minimum dosage, wrecking careers and friendships.