Suggest Safe Antidepressants For An Elderly Person

Brief Answer:
Careful monitoring wd be more wiser than changing. Let me know exact sympto

Detailed Answer:
Hello , I am Dr. Mody and I would be addressing your concern.

As I start I would like to know the symptoms you are facing so I can determine if they are due to medication and if yes , which is the culprit and hence balance out risk / benefit for each medication for you .

So please do send me all the symptoms you have .

Now as you are very right that some medication can cause more side effects in elderly as the metabolism and particularly the kidney and liver function changes with age , however I am of a strong belief that as you have been taking the medication for 50 long years sudden changing is NOT wise , rather more frequent monitoring of the side effects should be done to prevent any future untoward event and substitute one only if that is the reason of all your symptoms.

1) celol is heart selective beta blocker so all the side effects you read are not commonly seen with it .

However you may feel more tired , libido may decrease as a common problem. Hence keeping a tab on your pulse rate and checking sugar every 6 months is justified.

2) The bendrofluazide is a diuretic and is notorious to cause depletion of sodium and potassium and increase your uric acid leading to subtle cognitive slowing , gait disturbance ( low sodium ) , muscle pains ( low potassium ) and joint pain ( uric acid ) , do every 3 monthly check creatinine, electrolytes and uric acid .

3) Candesetran may increase potassium and effect your kidney status , however it's most safe acid nd effective medication of the three .

Every drug has listing of loads of side effects however it's present in less than 1 % of patients taking them .

So according to your symptoms we can change the culprit medication after evaluation and ruling out other cause and add calcium channel blockers which would be very safe at your age and efficacious.
Let me know the symptoms and I would advice like wise .

Any clarification needed , I would be happy to help .

Regards
Dr Priyank Mody

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Brief Answer:
Changing BP medication is not justified in your case

Detailed Answer:
Hello ,
I would enumerate my observations.
1) As I said I am not defending the fact that the blood pressure medication may have side effects , however considering your systolic blood pressure is still high and so continuation is justified and even the other medication for blood pressure will have its own drawbacks and considering your body system has accommodated with the present medication for 50 years changing is on basis of the symptoms you have mentioned is not a good option .
2) The difference between the systolic and diastolic BP id very common in older age group as the elasticity of the arteries decrease , however it will not cause any problem and rather is an adaptive phenomenon so blood reaches the exercising muscles more effectively.
3) The disturbance in sleep and cough may be because of post nasal drip due to rhinitis .
No medication you are on causes rhinitis
4) The joint pain and peripheral neuritis may be the result of autoimmune syndrome you have been diagnosed.
Rather sometimes there are chances of kidney involvement loss of protein which will be taken care of by candesartan.
5) long term celiprolol , if we suddenly stop they will be reflex increase in your heart rate and blood pressure which can be detrimental.
6) diuretic in older age may cause electrolyte imbalance which is even more significant I'd the skin involvement in usher syndrome is large .
One may add CCB like amlodipine to control the blood pressureand may replace the diuretic with the same.
Lastly the decrease in exercise capacity may point towards and underlying heart condition, an echocardiography and treadmill test would help us in its evaluation.
Let me know if any clarification needed furthur and I would be happy to help .
Do rate for other pals reference
Regards Dr Priyank Mody

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