Antidepressant to avoid in the elderly?

Antidepressant to avoid in the elderly?

• A. Paroxetine
• B. Sertraline
• C. Citalopram
• D. Fluoxetine

Answer: (A)

In older adults, avoid antidepressants with strong anticholinergic effects because they can worsen memory, cause confusion or delirium, and increase the risk of constipation, urinary retention, and falls. Paroxetine has the most pronounced anticholinergic activity among common SSRIs, making it more likely to cause these cognitive and functional problems in the elderly. The other options—sertraline, fluoxetine, and citalopram—have much less anticholinergic impact and are generally better tolerated in this population. Do keep in mind that citalopram has its own warning about QT prolongation in older adults, so it should be used cautiously and at appropriate doses.

In older adults, avoid antidepressants with strong anticholinergic effects because they can worsen memory, cause confusion or delirium, and increase the risk of constipation, urinary retention, and falls. Paroxetine has the most pronounced anticholinergic activity among common SSRIs, making it more likely to cause these cognitive and functional problems in the elderly. The other options—sertraline, fluoxetine, and citalopram—have much less anticholinergic impact and are generally better tolerated in this population. Do keep in mind that citalopram has its own warning about QT prolongation in older adults, so it should be used cautiously and at appropriate doses.