Use of serotonergic drugs for treating depression in older patients

The selective serotonin reuptake inhibitors (SSRIs) offer a relatively new alternative to traditional tricyclic antidepressants (TCAs) in the treatment of depression in older adults. The two drug classes are equally effective, but SSRIs tend to cause fewer sedating, anticholinergic, or hypotensive effects and are unlikely to affect cardiac conduction. SSRIs also have a wider therapeutic window and are safer in cases of overdose. Potential side effects include GI distress, worsening of headaches, insomnia, and sexual dysfunction. Drawbacks of using SSRIs are their potential for drug interactions and relatively high cost.