IntroductionWith their ease of administration, relatively benign side-effect profile and safety
in overdose, in the United States the selective serotonin reuptake inhibitors (SSRIs)
have become de facto first choice in the treatment of geriatric depression, displacing
tricyclic antidepressants (TCAs). In this paper, the relevant literature regarding
neurochemistry, kinetics, dosing, efficacy and differential side-effect profiles
of citalopram, fluvoxamine, fluoxetine, sertraline, and paroxetine, the five currently
available SSRIs in the USA, will be reviewed with special emphasis on geriatric data.
Of late, considerable controversy has been generated regarding whether SSRIs are
as effective as TCAs in severe and melancholic depressive subtypes. This important
issue will be explored and the relative utility of all the SSRIs in the elderly patient
compared and contrasted. Finally, reasons for difficulties in comparing results across
studies will be elucidated.
Pharmacokinetics, Clinical Effect and Side Effect of New Antidepressants, SSRI: 3. Pharmacogenetics of Selective Serotonin Reuptake Inhibitors
