Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-22T18:01:14.486Z Has data issue: false hasContentIssue false

An Overview of Fluoxetine in Geriatric Depression

Published online by Cambridge University Press:  06 August 2018

John P. Feighner*
Affiliation:
Feighner Research Institute, La Mesa, California, USA
William F. Boyer
Affiliation:
Feighner Research Institute, La Mesa, California, USA
Charles H. Meredith
Affiliation:
Feighner Research Institute, La Mesa, California, USA
Gordon Hendrickson
Affiliation:
Feighner Research Institute, La Mesa, California, USA
*
Corresoondence

Extract

During the past 75 years, the proportion of elderly individuals in the USA has grown twice as fast as the general population. Depression in this age-group occurs four times more frequently than in the general population (Butler, 1975), and the suicide rate for people over 65 years of age is 15 times greater than that of the general population (Lehman, 1980).

The elderly may be more susceptible to depression due to biological and/or psychosocial variables. Elderly people experience significant losses associated with increasing age, including death of spouse and friends, loss of work, social status, and physical and mental abilities (Lehman, 1980). The biogenic amine hypothesis suggests that the aging brain may experience a decrease in the functional availability of neurotransmitters (Lehman, 1980); this decrease may also play a role in the aetiology of depression.

Due to age-related changes in the body, the elderly can be more sensitive to drug therapy. Older patients may require careful dosage adjustments and may also be more prone to experiencing drug-related adverse events. The elderly often receive medication for various indications, and drug interactions are a concern (Thompson et al, 1983). Therefore, efficacy and safety studies of new antidepressants in elderly patients are particularly important. We pooled data from both double-blind and open-label studies to evaluate the efficacy and safety of fluoxetine in geriatric outpatients with DSM-III major depression. Positive results of fluoxetine in the treatment of geriatric depression were reported in one of these studies (Feighner & Cohn, 1985). The favourable safety and side-effect profile of fluoxetine in the general population has been discussed elsewhere (Wernicke, 1985). Plasma concentrations of fluoxetine in elderly subjects are similar to those in younger individuals (I.emberger et al, 1985). These findings, combined with a lack of cardiovascular effects (Fisch, 1985), and low lethality with overdose, indicated promise for fluoxetine as a geriatric antidepressant.

Type
Research Article
Copyright
Copyright © 1988 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Butler, R. N. (1975) Psychiatry and the elderly: An overview. American Journal of Psychiatry, 132, 893900.Google Scholar
Feighner, J. P. & Cohn, J. B. (1985) Double-blind comparative trials of fluoxetine and doxepin in geriatric patients with major depressive disorder. Journal of Clinical Psychiatry, 46, 2025.Google Scholar
Fisch, C. (1985) Effect of fluoxetine on the electrocardiogram. Journal of Clinical Psychiatry, 46, 4244.Google Scholar
Lehman, H. E. (1980) Recognition and treatment of depression in geriatric patients. In Clinical Depressions: Diagnostic and Therapeutic Challenges (ed. Ayd, F. J.). Baltimore, Maryland: Ayd Medical Communications.Google Scholar
Lemberger, L., Bergstrom, R. F., Wolen, R. L., Farid, N. A., Enas, G. G. & Aronoff, G. R. (1985) Fluoxetine: clinical pharmacology and physiologic disposition. Journal of Clinical Psychiatry, 46, 1419.Google Scholar
Thompson, T. L., Moran, M. G., Nies, A. S. (1983) Psychotropic drug use in the elderly. New England Journal of Medicine, 308, 194238.Google ScholarPubMed
Wernicke, J. F. (1985) The side effect profile and safety of fluoxetine. Journal of Clinical Psychiatry, 46, 5967.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.