FLUOXETINE IN ELDERLY PATIENTS - IS THERE CAUSE FOR CONCERN

Objective: To assess whether fluoxetine use is associated with significant weight loss or other side effects in depressed elderly patients with concomitant medical illness. Design: A retrospective chart review. Setting: A tertiary care VA hospital. Patients: Five groups of outpatients were studied: (1) patients greater than 75 years old receiving fluoxetine (n = 15); (2) patients 60 to 71 years old receiving fluoxetine (n = 20); (3) patients greater than 75 years old receiving nortryptiline or desipramine (n = 20); (4) patients greater than 75 years old with a history of depression but on no antidepressant medication (n = 20); and (5) patients greater than 75 years old with no history of depression (n = 28). Measurements: Mortality, change in weight, reports of anorexia or nausea, and serum sodium and glucose measurements. Main Results: Patients greater than 75 years of age taking fluoxetine experienced significantly greater weight loss (average 4.6 kilograms, P = 0.0062) than the other groups. Both groups of patients taking fluoxetine were significantly more likely to report nausea (P = 0.0095) and anorexia (P = 0.0009). No significant differences were noted in mortality or the frequency of hypoglycemia or hyponatremia between groups. Conclusion: The frequency and degree of weight loss noted here in medically ill elderly receiving fluoxetine warrants further investigation.