Izlaganje sa skupa
SERTRALINE AND MIRTAZAPINE AS GERIATRIC ANTIDEPRESSANTS
Jonathon Holland
; Department of Medicine for the Elderly, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
Madhavi Bhogle
; Department of Medicine for the Elderly, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
Sažetak
Background: Depression within the geriatric patient population is an important issue as it is associated with increased
mortality. Such depression may have a different aetiology to that in younger patients and be associated with comorbid chronic
physical health problems or cognitive impairment. However, there is no specific UK guideline for the treatment of depression within
elderly patients. The first-line pharmacological treatment recommended by the National Institute for Health and Care Excellence
(NICE) is to use a serotonin-selective reuptake inhibitor (SSRI). Unfortunately these can have significant side-effects in the elderly
such as hyponatraemia. Sertraline is one such SSRI commonly used in the geriatric population. Mirtazapine, a noradrenergic and
specific serotonergic antidepressant (NaSSa) is seeing increasing usage as an alternative agent. Here we evaluate the role of using
the NaSSA in place of the SSRI and how such drugs may be cross-titrated.
Methods: PubMed and an internet search engine were used to identify relevant studies and information sources.
Conclusions: Limited evidence suggests that for certain elderly patients, mirtazapine may be preferable to sertraline for
treatment of depression. It may also be more cost-effective in patients who have dementia. The choice is highly dependent upon
individual co-morbidities and subsequent polypharmacy. If required, sertaline can be cross-titrated to mirtazapine.
Ključne riječi
depression; geriatrics; sertraline; mirtazapine
Hrčak ID:
266694
URI
Datum izdavanja:
26.8.2013.
Posjeta: 318 *