Antidepressant-associated side effects in older adult depressed patients

Most patients with clinical depression are evaluated and treated by primary care physicians. Antidepressants remain the cornerstone of treatment. Selective serotonin reuptake inhibitors (SSRIs) are the drugs of choice, as they are virtually devoid of the cardiotoxicity and anticholinergic and hypotensive effects associated with tricyclic antidepressants and monoamine oxidase inhibitors. Side effects of SSRIs include GI upset, sexual dysfunction, hypotension, and sleep impairment. Side effects may contribute to abrupt discontinuation of antidepressants, and the abrupt discontinuation of SSIRIs is associated With discontinuation syndrome. In selecting antidepressants for the older adults, clinicians must consider age of patients, pharmacodynamics and pharmacokinetics of antidepressants, and side effects.