Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

Which of the following medications is considered to have the least side effects for elders?

1. Tricyclic antidepressants

2. Selective serotonin reuptake inhibitors

3. Serotonin-norepinephrine reuptake inhibitors

4. Dopamine-norepinephrine reuptake inhibitors

The correct answer is: Selective serotonin reuptake inhibitors

Selective serotonin reuptake inhibitors (SSRIs) are often considered to have the least side effects for older adults compared to other classes of antidepressants. This is due to their favorable safety profile and lower risk of anticholinergic side effects, which can be particularly problematic in the elderly population. SSRIs work by increasing serotonin levels in the brain, which can help alleviate symptoms of depression and anxiety. They tend to have a more favorable side effect profile, including less sedation and cognitive impairment, which are critical considerations in older adults who may be more vulnerable to these effects. Additionally, SSRIs are generally associated with a lower risk of cardiovascular complications, which is an important consideration in this age group given the prevalence of cardiovascular disease among older adults. In contrast, tricyclic antidepressants (TCAs) have a higher likelihood of causing anticholinergic side effects, sedation, and cardiotoxicity, making them less suitable for elderly patients. Similarly, serotonin-norepinephrine reuptake inhibitors (SNRIs) and dopamine-norepinephrine reuptake inhibitors may cause increased blood pressure or other cardiovascular issues, as well as other adverse effects that can be particularly challenging for the older population. Thus, SSRIs are often the recommended first-line