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What are the precautions in antidepressant usage in elderly? What is the safe therapy of depression in elderly like? My mother has decreased liver function that can not be treated and need to take antidepressants. She also uses calcium blockers for high blood pressure. What do you think about potential therapy in these conditions?

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There is a great variety of risk among elderly patients. Individual variability is the most important factor of precaution. Diseases like renal or hepatic are limiting factors for all drugs usage. It’s because of their role in elimination and possibilities of higher concentrations and toxicity in therapeutic doses. Then, diet and nutritional habits, smoking, alcohol use, and using of other drugs can affects on antidepressant effects. Antidepressants interact with plenty of medications because of their specific metabolic way in liver. I think that monitoring is needed in elderly patients on antidepressants.
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Educate yourself on the medications and her disease process. Consult with a doctor or pharmacist that you feel comfortable with and that expain things so that you understand. You need to weigh the risks versus the benefits. I think there are very few medications out there that don't effect the liver so it is likely a losing battle in that perspective. Sometimes it is trial and error too. Depression is a tought thing, and you certainly don't want your elderly parent to get depressed and remember that if she goes off the antidepresant, they can take weeks to be beneficial if you have to restart them.
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