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Related Concept Videos

Depression: Overview01:18

Depression: Overview

Depression is a prevalent mental illness marked by persistent sadness and lack of interest in previously enjoyable activities. It can take several forms, including major depression, persistent depressive disorder, and bipolar I and II disorders. Symptoms range from emotional changes like chronic worry to physical changes like sleep disturbances and suicidal thoughts. From a neurobiological perspective, depression is believed to be triggered by abnormalities in the brain's prefrontal cortex,...
Antidepressant Drugs: Overview01:25

Antidepressant Drugs: Overview

Antidepressant drugs are a class of medications primarily used for treating various mood disorders, including major depression, anxiety disorders, and other related conditions. These medicines work by modulating the neurotransmitter balance within the brain, alleviating depressive symptoms. Antidepressants can be broadly categorized into several groups according to their mechanism of action and chemical structure: Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine...
Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs01:28

Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs

Tricyclic Antidepressants (TCAs), including Desipramine (Norpramin), Imipramine (Tofranil), Clomipramine (Anafranil), and Amitriptyline (Elavil), inhibit serotonin and norepinephrine reuptake and also block other receptors. They are used for depression, pain conditions, and insomnia. Common adverse effects include anticholinergic effects, sedation, orthostatic hypotension, and weight gain. They have a narrow therapeutic window and so require plasma-level monitoring. Abrupt discontinuation can...
Antidepressant Drugs: MAOIs and Other Agents01:23

Antidepressant Drugs: MAOIs and Other Agents

Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
Treatment Strategies for Psychological Disorders01:24

Treatment Strategies for Psychological Disorders

Treatment approaches for psychological disorders fall into three main categories: psychological, biological, and sociocultural. Each approach targets different aspects of mental health, requiring varying levels of education and training.
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
Drug Therapy01:28

Drug Therapy

The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications

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Related Experiment Video

Updated: Jun 29, 2026

Behavioral Disturbances: An Innovative Approach to Monitor the Modulatory Effects of a Nutraceutical Diet
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Recent developments in antidepressant therapy in special populations.

Daniel Hayes1

  • 1Medical Technology Policy Review and Development, West Linn, Oregon, USA.

The American Journal of Managed Care
|September 10, 2004
PubMed
Summary

Selective serotonin reuptake inhibitors (SSRIs) are effective for elderly depression, but dosage adjustments may be needed for recurrence. SSRIs may also benefit patients with heart conditions.

Area of Science:

  • Geriatric Psychiatry
  • Cardiovascular Psychiatry
  • Child and Adolescent Psychiatry

Background:

  • Major Depressive Disorder (MDD) significantly impacts the quality of life in the elderly, often overlooked.
  • Comorbid MDD in elderly patients, children, and those with cardiovascular conditions like unstable angina or acute myocardial infarction (MI) presents unique treatment challenges.
  • SSRIs are generally preferred for elderly MDD due to their efficacy and side-effect profile, even with medical comorbidities.

Purpose of the Study:

  • To review the efficacy and safety of Selective Serotonin Reuptake Inhibitors (SSRIs) in specific populations: the elderly, children, and patients with acute myocardial infarction (MI).
  • To discuss treatment strategies for elderly patients with MDD, including maintenance, recurrence prevention, and dosage adjustments.
  • To evaluate the potential cardiovascular benefits of SSRIs in patients with comorbid depression and coronary artery disease.

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Main Methods:

  • Review of current evidence and clinical trial findings regarding SSRI use in elderly, pediatric, and cardiovascular patient populations.
  • Analysis of treatment outcomes, side-effect profiles, and recurrence rates associated with SSRIs and other antidepressants (e.g., venlafaxine) in the elderly.
  • Examination of data from studies like the Sertraline Anti-Depressant Heart Attack Randomized Trial (SADHEART) on SSRIs' cardiovascular effects.

Main Results:

  • SSRIs demonstrate a favorable efficacy and side-effect profile for MDD in the elderly, irrespective of comorbidities.
  • Venlafaxine may be an alternative for SSRI non-responders, but frail elderly patients might be more susceptible to its side effects.
  • Long-term maintenance and potentially increased dosages of antidepressants are crucial for preventing recurrence in elderly patients.
  • SSRIs may offer cardiovascular benefits, including antiplatelet and endothelium-protective properties, for patients with depression and coronary artery disease.
  • Evidence suggests potential risks of SSRIs (excluding fluoxetine) may outweigh benefits in treating depression in children and adolescents.

Conclusions:

  • SSRIs are a primary treatment for MDD in the elderly, with careful consideration for dosage and maintenance to prevent recurrence.
  • Antidepressant treatment should be considered for patients with MDD and comorbid cardiovascular conditions, given potential benefits of SSRIs.
  • Caution is advised regarding SSRI use in children and adolescents, with fluoxetine being a potential exception.