Risk profile of SSRIs in elderly depressive patients with co-morbid physical illness

Background: So far, most studies on treatment strategies in elderly depress ive patients have included only patients in good physical health, thereby e xcluding and neglecting somatic co-morbidity, which is very prevalent and r elevant in geriatric psychiatry. Method: 40 elderly depressive inpatients a t the Department of Internal Medicine in Hochzirl who had started on SSRI m onotherapy were allocated to this prospective post-marketing surveillance s tudy. A stable medication for their physical illness for at least six month s was a prerequisite. A Mini Mental State Exam (MMSE) score of > 24 was req uired for study entry. The four-week study consisted of one baseline and fo ur follow-up examinations, including psychiatric and medical history, as we ll as ratings for psychopathology and treatment-related adverse events. The antidepressants administered were paroxetine (20 mg/d), citalopram (20 mg/ d), fluoxetine (20 mg/d) and sertraline (50 mg/d). Depression was rated usi ng the 21-item Hamilton Depression Scale (HAMD); side effects were evaluate d by the UKU Side Effect Rating Scale, and we used the Hillside Akathisia S cale (HAS) to record the incidence of SSRI-induced akathisia. Results and C onclusion: Our results suggest that SSRIs are effective and reasonably safe in elderly depressive patients with co-morbid physical illness. Adverse ef fects are more common, but generally tolerable, than in younger and physica lly healthy patients. The risk profile of SSRIs in this population can be c onsidered favorable.