Evaluation of the use of Tricyclic Antidepressants Vs. Selective Serotonin Reuptake Inhibitors and Benzodiazepines in Geriatric Patients

To evaluate the use of tricyclic antidepressants, selective serotonin reuptake inhibitors and benzodiazepines in elderly patients aged over 60 years. Prospective, cross sectional, descriptive type of study was carried out in the general medicine department of a 640 bedded multispecialty tertiary care teaching hospital, South India. Benzodiazepines were prescribed in 79.6% patients, selective serotonin reuptake inhibitors in 12.3% and tricyclic antidepressants in 8.27%. The study identified 81.7% inappropriateness in prescriptions. Initiation of treatment with high dose after admission contributed to 32.6% while prescribing without proper indication accounted for 31.7%. Significant reduction of inappropriateness (48%) was observed during the post implementation phase, especially in the number of prescriptions of tricyclic antidepressants. The initial dose of alprazolam was reduced to 0.25 mg in all elderly patients. Prescribing benzodiazepines without proper indication reduced from 31.7% to 22%. Long acting benzodiazepines were not prescribed during this phase. The study demonstrated an overall improvement in the prescribing pattern of tricyclic antidepressants, selective serotonin reuptake inhibitors and benzodiazepines in elderly patients. Key Words: Antianxiety agents, tricyclic antidepressants, selective serotonin reuptake inhibitors, benzodiazepines, elderly, prescriptions.