Table 35.3—Selective Serotonin-Reuptake Inhibitors for Older Adults

Generic (Trade) Name

Initial Dosage

Final Dosage

Sedative Potential

Precautions

Advantages

Citalopram (Celexa)

10 mg am

20–40 mg am

Low

Side effects include nausea, tremor, dizziness, sweating, agitation

Few drug interactions, well tolerated

Escitalopram (Lexapro)

10 mg am

10–20 mg am

Low

Nausea, tremor, dizziness, sweating, agitation

May have fewer side effects than citalopram, well tolerated

Fluoxetine (Prozac)

10 mg am

 

20–40 mg am

Low

Nausea, tremor, dizziness, sweating, agitation, prolonged half-life, insomnia, drug interactions

Liquid preparation available

Paroxetine (Paxil)

10 mg hs

20–40 mg hs

Low

Nausea, tremor, dizziness, sweating, agitation, drug interactions, anticholinergic effects

Mild sedative effect

Sertraline (Zoloft)

25 mg am

100–200 mg am

Low

Nausea, tremor, dizziness, sweating, agitation

Few drug interactions, well tolerated

 

NOTE: am = ante meridiem or before noon; hs = hora somni or at bedtime.