Adverse reactions of antidepressants in elderly patients

As patients age, adverse drug reactions increase dramatically in frequency and severity. Although the population of elderly patients in controlled studies of antidepressants is small, key factors have been identified that may influence proper dosing, including the different pharmacokinetic properties of antidepressants in elderly compared with younger patients and individual patient characteristics. In elderly patients, antidepressant side effects of concern include orthostatic hypotension, anticholinergic effects, extrapyramidal symptoms, and syndrome of inappropriate antidiuretic hormone secretion. A routine treatment procedure that includes risk-factor identification, a thorough drug history, patient and caregiver education on compliance, and use of the lowest effective dose can help clinicians effectively manage elderly patients and limit the risk of adverse drug reactions.