SSRIs are generally preferred over older tricyclic antidepressants in elderly pa...
Depression in older adults is a highly treatable condition, yet the pharmacological management of depression in this population requires careful drug selection, dose titration and ongoing monitoring that differs significantly from younger adults. Physiological changes associated with ageing — including reduced renal and hepatic drug clearance, altered drug distribution, increased blood-brain barrier permeability and heightened sensitivity to central nervous system effects — all influence how antidepressants behave in elderly patients.
Selective serotonin reuptake inhibitors (SSRIs) are the first-line pharmacological treatment for depression in most older adults, given their relatively favourable side-effect profile compared to tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). However, SSRIs are not without risk: hyponatraemia (low blood sodium) is a significant concern, particularly in the first weeks of treatment, and can present as confusion, lethargy or falls. Nurses must monitor for these signs, ensure baseline electrolytes are checked and repeat testing arranged after initiation.
Mehermedics-placed nurses receive specific training in psychotropic medication monitoring in older adults, including the use of validated tools for detecting drug-induced adverse effects and the protocols for liaising with prescribers when concerns arise.
