What is the first-line treatment for depression in the elderly?

Citalopram is widely recognized as one of the first-line treatments for depression in the elderly. This selective serotonin reuptake inhibitor (SSRI) is favored for several reasons, primarily due to its efficacy, safety profile, and tolerability in older adults.

In treating depression among the elderly, SSRIs are typically preferred over older tricyclic antidepressants like amitriptyline because they are less likely to cause significant side effects, such as sedation, anticholinergic effects, and cardiovascular complications. Citalopram, in particular, has a favorable side effect profile and is effective at lower doses, which is often crucial when considering the overall health and medication burden of older patients.

Furthermore, citalopram has been shown to have a lower incidence of drug interactions compared to other medications, making it a practical choice in the elderly population, who often take multiple medications for various chronic conditions. It’s important to monitor patients closely, especially in the initial stages of treatment, to assess for response and any potential side effects, but citalopram remains a strong option for managing depression effectively in older adults.

The other medications listed, while they may be effective for depression, do not hold the same level of preference as