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antidepressants elderly

H Karl Greenblatt, David J Greenblatt
No abstract text is available yet for this article.
October 13, 2016: Journal of Clinical Psychopharmacology
Jennifer L Schroeck, James Ford, Erin L Conway, Kari E Kurtzhalts, Megan E Gee, Krista A Vollmer, Kari A Mergenhagen
PURPOSE: Insomnia is problematic for older adults. After behavioral modifications fail to show adequate response, pharmacologic options are used. The pharmacokinetics of agents used to treat insomnia may be altered. This review focuses on the safety and efficacy of medications used to treat insomnia. METHODS: A literature search of Medline, PubMed, and Embase was conducted (January 1966-June 2016). It included systematic reviews, randomized controlled trials, observational studies, and case series that had an emphasis on insomnia in an older population...
October 14, 2016: Clinical Therapeutics
Jennifer G Naples, Mary P Kotlarczyk, Subashan Perera, Susan L Greenspan, Joseph T Hanlon
OBJECTIVE: To determine the risk of recurrent falls associated with antidepressants other than tricyclics (TCAs) and selective serotonin reuptake inhibitors (SSRIs) among frail older women. METHODS: This is a secondary analysis of the Zoledronic acid in frail Elders to STrengthen bone, or ZEST, trial data treated as a longitudinal cohort in 181 frail, osteoporotic women aged ≥65 years in long-term care. The primary exposure was individual non-TCA/non-SSRI antidepressants (i...
August 17, 2016: American Journal of Geriatric Psychiatry
Robert M Nevels, Samuel T Gontkovsky, Bryman E Williams
Paroxetine, also known by the trade names Aropax, Paxil, Pexeva, Seroxat, Sereupin and Brisdelle, was first marketed in the U.S. in 1992. Effective for major depression and various anxiety disorders, it quickly gained a sizable share of the antidepressant prescription market. By the late 1990s, paroxetine frequently was being associated with serious drug interactions and medication side effects. Most significantly, in a major Canadian epidemiological study examining the relationship between antidepressants and diseases, paroxetine was associated with a 620 percent increase in the rate of breast cancer in women who had taken it over a four-year period...
March 1, 2016: Psychopharmacology Bulletin
Diana Wucherer, Tilly Eichler, Johnanes Hertel, Ingo Kilimann, Steffen Richter, Bernhard Michalowsky, Jochen René Thyrian, Stefan Teipel, Wolfgang Hoffmann
BACKGROUND: Potentially inappropriate medication (PIM) in older people is a risk factor for adverse drug effects. This risk is even higher in older people with dementia (PWD). OBJECTIVE: Our study aimed to determine (1) the prevalence of PIM among primary care patients who were screened positive for dementia and (2) the sociodemographic and clinical variables associated with the use of PIM. METHODS: DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) is a general practitioner-based, cluster-randomized, controlled intervention study to implement and evaluate an innovative concept of collaborative dementia care management in Germany...
October 5, 2016: Journal of Alzheimer's Disease: JAD
Sibel Cakir, Zeynep Senkal
BACKGROUND: Second-generation antipsychotics (SGAs) have been used in the augmentation of treatment-resistant depression. However, little is known about their effectiveness, tolerability, and adverse events in the treatment of late-life depression, which were the aim of this study. METHODS: The retrospective data of patients aged >65 years who had a major depressive episode with inadequate response to antidepressant treatment and had adjuvant SGA treatment were analyzed...
2016: Clinical Interventions in Aging
Brian C Lund, Mary E Charlton, Alan N West
BACKGROUND: Utilization of private sector healthcare services among dual enrolled veterans with private healthcare insurance plans (PHIP) has not been well-characterized. Concurrent use of Veterans Health Administration (VHA) and non-VHA pharmacies may increase risk for adverse outcomes. Thus, the objectives of this study were to determine the extent to which dual VHA-PHIP enrollees obtain medications through VHA and non-VHA pharmacies and to characterize medications obtained through non-VHA pharmacies...
2016: BMC Health Services Research
Claudia A Cox, Heike J van Jaarsveld, Saskia Houterman, John C G H van der Stegen, Arthur T M Wasylewicz, Rene J E Grouls, Carolien M J van der Linden
BACKGROUND: Falling is a common and serious problem in the elderly. Previous studies suggest that the use of psychotropic drugs increases the risk of falling. However, the contribution of these drugs on fall risk has not been quantified on a daily basis among the general population of nursing homes until now. OBJECTIVE: To assess the association between fall incidence and the prescription of psychotropic drugs and different categories of psychotropic drugs (antipsychotics, antidepressants, and benzodiazepines) among a general nursing home population...
September 16, 2016: Journal of the American Medical Directors Association
Zhongyong Shi, Shifu Xiao, Xia Li
The current case describes a 78-year-old female with two previous episodes of major depression who presented with both symptoms of depression (amotivation and flattened affect) and typical symptoms of dementia (impaired memory and executive functioning). Even after a detailed clinical exam and neuropsychiatric testing, it remained difficult to definitively classify the diagnosis as either treatment-resistant depression or old-age dementia. After 8 weeks of inpatient treatment, including changing her reserpine-based antihypertensive medication, adjusting her antidepressants, and providing psychotherapy, her depressive and anxiety symptoms improved, but most of her cognitive symptoms persisted...
April 25, 2016: Shanghai Archives of Psychiatry
Sarah Shizuko Morimoto, Faith M Gunning, Bruce E Wexler, Willie Hu, Irena Ilieva, Jiacheng Liu, Juliana Nitis, George S Alexopoulos
OBJECTIVES: Executive dysfunction (ED) is a predictor of poor treatment response of late-life depression to pharmacotherapy. In response to the consistency of these findings, we designed neuroplasticity-based computerized cognitive remediation (nCCR-GD) intervention to target and improve ED in patients who failed to remit with antidepressant treatment. This study tests the hypothesis that ED at baseline will predict favorable treatment response to nCCR-GD. METHODS: 11 elderly patients with treatment-resistant major depression were treated with a 30-hour, 4-week, unblinded, nCCR-GD treatment trial...
October 2016: American Journal of Geriatric Psychiatry
Benoit Cossette, Josée Bergeron, Geneviève Ricard, Jean-François Éthier, Thomas Joly-Mischlich, Mitchell Levine, Modou Sene, Louise Mallet, Luc Lanthier, Hélène Payette, Marie-Claude Rodrigue, Serge Brazeau
OBJECTIVES: To evaluate the effect of a knowledge translation (KT) strategy to reduce potentially inappropriate medication (PIM) use in elderly inpatients in the hospital. DESIGN: Segmented regression analysis of an interrupted time series. SETTING: Teaching hospital. PARTICIPANTS: Individuals aged 75 and older discharged from the hospital in 2013/14 (mean age 83.3, 54.5% female). INTERVENTION: The KT strategy comprises the distribution of educational materials, presentations by geriatricians, pharmacist-physician interventions based on alerts from a computerized alert system, and comprehensive geriatric assessments...
September 2, 2016: Journal of the American Geriatrics Society
Nikkie Aarts, Raymond Noordam, Albert Hofman, Henning Tiemeier, Bruno H Stricker, Loes E Visser
Background Population-based studies investigating indications for antidepressant prescribing mostly rely on diagnoses from general practitioners. However, diagnostic codes might be incomplete and drugs may be prescribed 'off-label' for indications not investigated in clinical trials. Objective We aimed to study indications for antidepressant use based on self-report. Also, we studied the presence of depressive symptoms associated with the self-reported indications. Setting Our study population of antidepressant users was selected based on interview data between 1997 and 2013 from the prospective population-based Rotterdam Study cohort (age >45 years)...
October 2016: International Journal of Clinical Pharmacy
Adomas Bunevicius, Paulius Cikotas, Vesta Steibliene, Vytenis P Deltuva, Arimantas Tamsauskas
BACKGROUND: Intracranial aneurysms most commonly present following rupture causing subarachnoid hemorrhage. Mental disorders are common among patients with unruptured intracranial aneurysms and in aneurysmal subarachnoid hemorrhage survivors. However, to the best of our knowledge, there is no published report of unruptured intracranial aneurysm presenting as a mental disorder. CASE DESCRIPTION: A 69-year-old male without a past history of mental disorders and neurological symptoms presented with a 2-month history of anxiety, sadness, lack of pleasure in usual activities, fatigue, difficulties falling asleep and waking up early in the morning, reduced appetite, and weight loss...
2016: Surgical Neurology International
Tabi Anika Leslie
Itch is a common symptom in the elderly population over 65 years old, and is often a chronic condition lasting more than 6 weeks. As in all age groups, but especially in the elderly, there can be a significant effect on the general health status and quality of life, with impaired daily activities and lack of sleep, which can also lead in some cases to depression or anxiety. The cause of chronic itch in the elderly is often multifactorial due to physiological changes in the aging skin, including impaired skin barrier function, and also due to decline in immunological (immunosenescence), neurological, and psychological changes associated with age...
2016: Current Problems in Dermatology
S A Onasanwo, S O Faborode, K O Ilenre
Buchholzia coriacea, taken by elderly, has phytochemicals that have neuro-active metabolites, and the folkloredocumented its use in neuro-behavioral despairs. Previous study in our laboratory shows that methanol extracts of Buchholziacoriacea (MEBC) seeds possess antidepressant-like potentials in laboratory rodents. This present study was conducted toinvestigate the probable mechanism(s) of action by which MEBC potentiates its effects using laboratory rodents.Involvements of serotonergic, cholinergic and adrenergic systems were studied using Forced Swimming Test (FST) and TailSuspension Test (TST) models of behavioral despair...
2016: Nigerian Journal of Physiological Sciences: Official Publication of the Physiological Society of Nigeria
Anna Przeklasa-Muszyńska, Magdalena Kocot-Kępska, Jan Dobrogowski, Maciej Wiatr, Joanna Mika
BACKGROUND: Neuropathic pain, is caused by damage or disease affecting the somatosensory nervous system, leads to deterioration of the quality of life of patients. Most commonly, this deterioration is due to the inefficacy of treatment or to the adverse effects of systemic treatment. Pharmacotherapy of neuropathic pain involves the use of antiepileptic agents, antidepressants, and opioids that may lead to numerous adverse effects, particularly in elderly patients. Intravenous infusions of lidocaine may improve the efficacy of the analgesic treatment of neuropathic pain patients while not causing any significant adverse effects...
October 2016: Pharmacological Reports: PR
Kuan-Ling Kuo, Diana Brixner, Arthur G Lipman, Michael Goodman, Man Hung, Gary M Oderda
This study compared patient characteristics and health care costs between newly treated diabetic painful neuropathy (DPN) patients receiving mono- pharmacotherapy and those receiving combination pharmacotherapy. A retrospective cohort was developed through Inovalon's Medical Outcomes Research for Effectiveness and Economics Registry (MORE2) database. Patients included were ≥18 years on the date of first DPN prescription: tricyclic antidepressant, opioids, duloxetine, gabapentin, pregabalin, or lidocaine. The authors conducted a simple proportional hazards model comparing times to discontinuation, switch, or addon...
September 2016: Journal of Pain & Palliative Care Pharmacotherapy
Jun Ku Chung, Shinichiro Nakajima, Shunichiro Shinagawa, Eric Plitman, M Mallar Chakravarty, Yusuke Iwata, Fernando Caravaggio, Bruce G Pollock, Philip Gerretsen, Ariel Graff-Guerrero
OBJECTIVE: It is inconclusive as to whether benzodiazepines (BZDs) are related to cognitive deterioration in the elderly populations. Animal studies suggest that γ-aminobutyric acid A receptor agonists, such as BZDs, may prevent Aβ-neurotoxicity and reduce β-amyloid (Aβ). However, no studies have investigated the effects of BZD use on Aβ in humans. METHODS: This cross-sectional, prospective study using Alzheimer's Disease Neuroimaging Initiative sites in the United States and Canada on nondemented elderly adults between 55 and 90 years of age assessed cortical Aβ levels by positron emission tomography radiotracer F(18)-Florbetapir...
November 2016: American Journal of Geriatric Psychiatry
Ulf Jonsson, Göran Bertilsson, Per Allard, Harald Gyllensvärd, Anne Söderlund, Anne Tham, Gerhard Andersson
OBJECTIVES: Depression in elderly people is a major public health concern. As response to antidepressants is often unsatisfactory in this age group, there is a need for evidence-based non-pharmacological treatment options. Our objectives were twofold: firstly, to synthesize published trials evaluating efficacy, safety and cost-effectiveness of psychological treatment of depression in the elderly and secondly, to assess the quality of evidence. METHOD: The electronic databases PubMed, EMBASE, Cochrane Library, CINAL, Scopus, and PsycINFO were searched up to 23 May 2016 for randomized controlled trials (RCTs) of psychological treatment for depressive disorders or depressive symptoms in people aged 65 years and over...
2016: PloS One
Ruth Lamb, Jonathan D Rohrer, Andrew J Lees, Huw R Morris
There are currently no disease-modifying treatments for progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD), and no approved pharmacological or therapeutic treatments that are effective in controlling their symptoms. The use of most pharmacological treatment options are based on experience in other disorders or from non-randomized historical controls, case series, or expert opinion. Levodopa may provide some improvement in symptoms of Parkinsonism (specifically bradykinesia and rigidity) in PSP and CBD; however, evidence is conflicting and where present, benefits are often negligible and short lived...
September 2016: Current Treatment Options in Neurology
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