The American Psychiatric Association (APA) recommends that selective serotonin reuptake inhibitors (SSRIs), such as citalopram (Celexa) and fluoxetine (Prozac), be used as first-line depression therapy for elderly people mainly because these drugs have less dangerous side effects than other antidepressants and are less
SSRIs considered to have the best safety profile in the elderly are citalopram, escitalopram, and sertraline.  These have the lowest potential for drug-drug interactions based on their cytochrome P-450 interactions.
There are many types of therapy available. Three of the more common methods used in depression treatment include cognitive behavioral therapy , interpersonal therapy , and psychodynamic therapy . Often, a blended approach is used.
This generation of antidepressants is now the most common class used for depression. Examples include citalopram ( Celexa ), escitalopram ( Lexapro ), paroxetine ( Paxil , Pexeva ), fluoxetine ( Prozac , Sarafem ), and sertraline ( Zoloft ).
Older adults also may have more medical conditions, such as heart disease, stroke, or cancer , which may cause depressive symptoms. Or they may be taking medications with side effects that contribute to depression.
Depression impacts older people differently than younger people . In the elderly , depression often occurs with other medical illnesses and disabilities and lasts longer. Depression in the elderly is associated with an increased risk of cardiac diseases and an increased risk of death from illness.
Buspirone is an anti-anxiety drug that has been shown to be effective for older adults. Benzodiazepines , another anti-anxiety drug, are effective but should be prescribed carefully to older adults because of risk of memory impairment, unsteadiness, and falls.
Tricyclic antidepressants , especially amitriptyline and dothiepin ,16 are known to pose a high risk of death in overdosage. These drugs should therefore be avoided in older people whose medication is not supervised and who are at risk of taking an overdose.
Diphenhydramine and amitriptiline are the most common inappropriately prescribed medications with high risk adverse events while propoxyphene and doxazoxin are the most commonly prescribed medications with low risk adverse events.
Consider sertraline and escitalopram as first-line agents for initial treatment of major depression in adults. The least tolerated antidepressants in this study were bupropion, fluoxetine, paroxetine, and duloxetine.
Stimulants . D- amphetamine (Dexedrine) and methylphenidate (Ritalin) are stimulants used to treat depression . They can be used as monotherapy, but they may also be used in a combination therapy with antidepressant medications. They’re most helpful when the desired effect is a quick response.
The Zung Scale is a screening tool used to help assess the level of depression in people who are depressed. It is a 20-question test that provides a score range from 20 to 80. Most depressed people score between 50 and 69. A score above that indicates severe depression.
Examples of SSRIs are: Prozac ( fluoxetine ) Paxil ( paroxetine ) Zoloft (sertraline) Celexa ( citalopram ) Luvox (fluvoxamine) Lexapro (escitalopram) Trintellix (vortioxetine) Viibryd (vilazodone)
The most effective antidepressants for adults revealed in major review escitalopram . paroxetine . sertraline . agomelatine . mirtazapine .
Zoloft is the most commonly prescribed antidepressant; nearly 17% of those survey in the 2017 antidepressant use study reported that they had taken this medication. 1 Paxil ( paroxetine ): You might be more likely to have sexual side effects if you choose Paxil over other antidepressants.