Older adults are at a higher risk of developing depression, and it is not a normal sign of aging nor normal reaction to certain events such as loss of loved ones. Eighty percent of older adults have at least one chronic condition, and 50 % have two or more chronic condition, making them more susceptible to depression (CDC, 2017).  it is significant to identify or assess older individuals for depression as this can influence or negatively impact their adherence to their medical treatment/management and quality of life. The ability to understand how antidepressant treat depression, how the body metabolize the drug and the different potential drug to drug interaction associated with antidepressant drug use can promote safety drug use and treatment adherence. It is vital for health providers to know the difference expected or common side effects of drugs and appropriate management of this side effects to promote medication adherence and compliance. The ability to understand how the drugs metabolizes and eliminated from the body will prevent drug toxicity especially among older adults when organ functions are declining.
Depression is caused by a deficiency of monoamine neurotransmitters such as norepinephrine and serotonin (Huethner, & McCance, 2017). Neurotransmitters are substances released by synaptic terminals into a specific receptor located on the postsynaptic cell allowing transmission of information from one nerve to the other (Purves, et al., 2001). Serotonin is a neurotransmitter necessary in many body functions such as appetite, memory, mood, social behavior, sexual desire, function and sleep (Campbell, 2018). Therefore, any alterations in Serotonin can lead to body function disruption as manifested in depression. since the patient is experiencing depression, it will be appropriate to initiate antidepressant drug. There are five major antidepressant drug classification that can be used based from the patient’s respond and tolerance; (a) Selective serotonin reuptake inhibitor (SSRI), (b) Serotonin-norepinephrine reuptake inhibitor (SNRI), (c) tricyclic antidepressant (TCAs), (d) monoamine oxidase inhibitor (MAOIs), and atypical antidepressants. SSRI such as Zoloft is the first line of treatment for depression due to its low adverse side effects, considering that the patient is an elderly, it is vital to select a drug that has the least adverse side effect as much as possible.
Centers for Disease Control and Prevention (CDC). (2017). Depression is not a normal part of growing older. Retrieved from https://www.cdc.gov/aging/mentalhealth/depression.htm
Campbell, J. (2018). Serotonin. Salem Press Encyclopedia of Health. Retrieved from https://search-ebscohost om.ezp.waldenulibrary.org/login.aspx? direct=true&db=ers&AN=100259358&site=eds-live&scope=site
Huethner, S., McCance, K. (2017). Understanding Pathophysiology. (6th ed.). St. Louis, MO: Mosby.
Purves D, Augustine GJ, Fitzpatrick D, et al. (2001). Neurotransmitter Release and Removal. Available from https://www.ncbi.nlm.nih.gov/books/NBK11106/