Elderly Pts.

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Elderly Pts.

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new_n_lost
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05/02/07 - 10:36 AM

Which of the following drugs is the least sedative and anticholenergic which can be prescribed safely to elderly patients with depression?

A) Fluoxetine
B) MAO inhibitor
C) Imipramine
D) Sertraline
E) Trazodon

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po
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05/02/07 - 11:09 AM

Most of the antidepressants are thought to be equally effective in elderly adults. The most commonly used and studied antidepressants have been nortriptyline and desipramine because they have a more favorable side effect spectrum than traditional antidepressants such as amitriptyline and imipramine. Most clinicians avoid these latter two medications because they cause significant orthostatic hypotension, which can cause falls and fractures, and because elderly patients are especially sensitive to their anticholinergic, cardiovascular, and sedative side effects.

Based primarily on clinical experience, many clinicians favor the newer antidepressants trazodone, bupropion, and fluoxetine because they have fewer anticholinergic and cardiovascular side effects. Contrary to widespread clinical opinion, the use of monoamine oxidase inhibitors, especially phenelzine, has been generally found to be safe and effective, but they have not been widely used for the treatment of geriatric depression.

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hst...

new_n_lost
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05/02/07 - 11:18 AM

Dude Whts ur Answer raised eyebrow

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po
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05/02/07 - 11:22 AM

is citalopram sertralin?

http://ajgponline.org/cgi/content/abstract/10/3/3...

looks like all drugs can be given safely except c.

po
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05/02/07 - 11:23 AM

patience nnl grin

new_n_lost
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05/02/07 - 11:26 AM

buddy i have patience but i cudnt figure which drug r u advocating for thru that article. So dont take this personally its also good to back ur answer with a reference but for that u have to choose an answer.

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SILVER
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05/02/07 - 11:43 AM

D. The mainstay of treating depression in elderly is to prescribe SSRIs. Of the choices given, fluoxetine and sertraline fall into that category. The ques. asks "which can be prescribed SAFELY". Fluoxetine (prozac) is less desirable than other SSRIs cuz it lingers in your body up to 6 weeks after you stop taking the drug. If a bad reaction occurs with sertraline (zoloft) the effects will last up to a week only.

The main thing about SSRIs is that it doesn't cause those undesirable effects that the other choices cause, like sedation and orthostatic hypotension. So SSRIs are preferred.

SSRIs have their own list of s/e but the main point is that they're not as severe as the s/e caused by other antidepressants. So they're safe.

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po
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05/02/07 - 12:04 PM

point taken nnl thank you.
silver is right,since trazodone though no anticholinergic effects has sedation +++.
silver ruled out fluoxetine.
MAO probably is a too complex with regard to drug interactions.

nice expln silver,thanks.

new_n_lost
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05/04/07 - 07:04 PM

silver wrote:
D. The mainstay of treating depression in elderly is to prescribe SSRIs. Of the choices given, fluoxetine and sertraline fall into that category. The ques. asks "which can be prescribed SAFELY". Fluoxetine (prozac) is less desirable than other SSRIs cuz it lingers in your body up to 6 weeks after you stop taking the drug. If a bad reaction occurs with sertraline (zoloft) the effects will last up to a week only.

The main thing about SSRIs is that it doesn't cause those undesirable effects that the other choices cause, like sedation and orthostatic hypotension. So SSRIs are preferred.

SSRIs have their own list of s/e but the main point is that they're not as severe as the s/e caused by other antidepressants. So they're safe.

lq2006
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05/20/07 - 11:36 PM

#10

sertralin

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