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Re: SSRIs in Elderly

Posted by SLS on December 19, 2009, at 4:24:47

In reply to Re: SSRIs in Elderly, posted by bleauberry on December 18, 2009, at 20:53:49

> > It does seem that the noradrenergic drugs are effective. Unfortunately, the drugs that would probably help with late-onset depression the most - the tricyclics - are the ones that are most problematic in the elderly with respect to side effects and toxicity.
> >
> >
> > - Scott
>
> Actually it would seem that way. But in the case studies and small studies I recall, the TCAs were actually better tolerated than the SSRIs. The reason may be because they better suited the chemistry, or maybe because the frail and elderly did not require high doses. Low doses did the job.

I was more concerned that there wasn't some sort of behavioral toxicity being produced by SSRI over-medication. Whether older people respond better to lower dosages of drugs when they are adjusted for differences in kinetics is another story. If she did not have heart disease, it would be interesting to try a small dose of nortriptyline. Now that I think about it, Effexor might be contraindicated if her blood pressure is elevated and not controlled well by antihypertensives. I'd have to read up on that.


- Scott

 

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poster:SLS thread:929718
URL: http://www.dr-bob.org/babble/20091217/msgs/929897.html