Antidepressants and older people

ANTIDEPRESSANTS are modestly effective for treating people aged 60 years or older with major depression,1 but adverse effects such as nausea and dizziness are common, and falls and hyponatraemia can occur.2-4 

The prevalence of polypharmacy in the aged population also increases the risk of drug interactions. To minimise adverse effects, start with a low dose, titrate carefully and monitor regularly.2 

Check electrolytes at baseline after one month.5 Note that the efficacy of antidepressants has not been demonstrated for treating depression in people with dementia.6

A recent UK study of 60,000 patients aged 65–100 years with depression found an increased risk of falls for people treated with any class of antidepressant compared with people who did not receive any antidepressant.7 

The same study also found a significantly increased risk of hyponatraemia with many