The Use of Monoamine Oxidase Inhibitors in the Treatment of Elderly, Depressed Patients

Jenike, Michael A.

doi:10.1111/j.1532-5415.1984.tb06134.x

Cited by 43 publications

(13 citation statements)

References 13 publications

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“…These doses require cutting the available tablets in half, which might be difficult for some elderly patients. Hypertensive crises are not more frequent in older patients, but the consequences can be more serious (53). Some older patients become paradoxically sedated from MAOIs, but this side effect is usually temporary.…”

Section: Use Of Maois In Patients With Neurologicalmentioning

confidence: 97%

Review Article: Psychopharmacologic Treatment in Neurological Practice

Dubovsky

Ringel

1987

Neurorehabilitation and Neural Repair

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Colorado 80262.Numerous medications are currently available to treat behavioral disturbances that are commonly encountered in neurological practice. This paper reviews psychopharmacotherapy of depression, mania, anxiety, agitation, and psychosis. The effects of commonly used psychotropic agents in neurological patients, particularly those who are elderly, are emphasized. DepressionDiagnosis At any given time, 4-6% of men and twice as many woman are clinically depressed; the lifetime risk of depression is approximately 12% for men and 25% for women (1). Depression is typically manifested by a disturbance in mood (depressed, irritable, and/or anxious), thinking (helplessness, hopelessness, negativism, suicidal thoughts, self-blame, lowered self-esteem, psychomotor slowing), and vegetative function (appetite and weight change, sleep disturbance, diurnal and seasonal variation in mood). Not infrequently, neurological illnesses and/or the medications used to treat them cause depression. For example, 50-70% of patients with left hemisphere strokes develop clinical depression (2-5). Anticonvulsants, tranquilizers, and corticosteroids are common causes of depression in neurological patients (6,7). Right hemispheral dysfunction, diffuse brain disease, and some personality disorders might interfere with the ability to express emotion directly so that depressed mood is &dquo;masked&dquo; by other complaints.Most common among these are disturbances of social functioning (e.g., marital problems, frequent job changes, personality deterioration, chronic insomnia), behavior (e.g., disheveled appearance, hostility, substance abuse, catatonia, agitation, failure to recover as expected from neurological illness), thinking, (e.g., negativism, noncompliance, pseudodementia, physical complaints, expression of a wish to die), or affect (e.g., inappropriate or labile affect) (3,7,8).

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Section: Use Of Maois In Patients With Neurologicalmentioning

confidence: 97%

Review Article: Psychopharmacologic Treatment in Neurological Practice

Dubovsky

Ringel

1987

Neurorehabilitation and Neural Repair

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“…Pure antihistamines, such as chlorpheniramine, however, can safely be used to treat patients who have rhinitis. 42,45 There is a poorly understood toxic interaction between MAOIs and meperidine hydrochloride, which was first described in 195546 and has been reported occasionally since that time. 47 Clinically, patients appear agitated, disoriented, cyanotic, hyperthermic, hypertensive, and tachycardiac.…”

Section: Monoamine Oxidase Inhibitorsmentioning

confidence: 98%

“…42 Many patients who do not respond to tricyclics or some of the newer antidepressants will improve with MAOIs. Also, MAOIs may be especially effective in treating depression related to dementia.…”

Section: Monoamine Oxidase Inhibitorsmentioning

confidence: 99%

Assessment and Treatment of Affective Illness in the Elderly

Jenike¹

1988

J Geriatr Psychiatry Neurol

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“…The physician should be alert for hypertensive crisis, which can be treated by phentolamine (Regitine), 5 mggiven slowly intravenously. 23 Tranylcypromine (Pamate), I 0 to 20 mg twice a day, has a shorter effect than phenelzine (Nardilt and is therefore preferred.…”

Section: Antidepressants and Monoamine Inhibitorsmentioning

confidence: 99%

Psychotropic drugs in the elderly

Barclay¹

1985

Postgraduate Medicine

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Caution is required when prescribing psychotropic drugs to elderly patients, because of altered pharmacokinetics. Benzodiazepines with a relatively short half-life, such as temazepam (Restoril), alprazolam (Xanax), and lorazepam (Ativan), are better hypnotics for the elderly than those with a long half-life. Lorazepam and clorazepate dipotassium (Tranxene) are appropriate anxiolytics for elderly patients. Antipsychotics have anticholinergic and extrapyramidal symptoms in varying degrees. Thiothixene (Navane) and haloperidol (Haldol) in low doses are the drugs of choice despite their extrapyramidal symptoms. Trazodone (Desyrel) is a good antidepressant for the elderly because of its minimal anticholinergic effects, although it is quite sedating. Desipramine (Norpramin) is the least sedating and has the fewest anticholinergic effects of the tricyclic antidepressants and therefore may be better tolerated. Monoamine oxidase inhibitors and lithium should be used with great caution.

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The Use of Monoamine Oxidase Inhibitors in the Treatment of Elderly, Depressed Patients

Cited by 43 publications

References 13 publications

Review Article: Psychopharmacologic Treatment in Neurological Practice

Review Article: Psychopharmacologic Treatment in Neurological Practice

Assessment and Treatment of Affective Illness in the Elderly

Psychotropic drugs in the elderly

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