Elderly Depression

Spike in Older Adults taking Antidepressants

Rates of depression among the elderly are skyrocketing due to the effects of the global pandemic and the social isolation that accompanies it, and the impact is greatest on the elderly. Studies show the elderly have higher rates of depression because of underlying medical problems and medications that place them at risk and due to higher rates of social isolation. Loneliness and isolation brought on by social distancing make it difficult for older people to stay in close contact with friends and family, and many aren’t comfortable enough with technology to stay in touch through social media.When older people experience depression, the symptoms may be severe enough to require medication. Research shows that up to 50% of people with depression also suffer from anxiety, and that makes finding the right medication or medications more challenging. Plus, aging changes how medications, including antidepressants, are metabolized and broken down by the body.

Antidepressants Have Side Effects

The elderly are also more likely to experience side effects from antidepressants. Some of these side effects are mild and not life-threatening, such as a dry mouth or dry eyes. However, more serious reactions to antidepressants may occur and include lightheadedness, excessive fatigue and sleepiness, irregular heart rhythms, and a drop in blood pressure when going from a sitting to a standing position. Some of these, like lightheadedness and a drop in blood pressure, increase the risk of falling.In the past, doctors often used trial and error to find the right antidepressant for a patient. They would try a medication and see how the patient responded. If the patient developed significant side effects or didn’t get benefits, they’d try another until they found the right fit. Yet this is not an effective or safe way to find the right medication to treat someone with depression. People vary in how they respond to a particular prescription. What works for one person may be ineffective for another. Ideally, you’d like to know the likelihood of a treatment working and being safe before asking a person to take it. That’s where a pharmacogenetic (PGx) testing comes in.

The Benefits of Pharmacogenetic (PGx) Testing for Older Adults Taking Antidepressants

PGx stands for pharmacogenomics and it’s a type of testing that looks at an individual’s genetics and how their genes will metabolize specific medications. Using this genetic information makes it easier to choose a medication that has a high likelihood of being effective and is least likely to have serious side effects. This approach eliminates the trial and error usually associated with finding the correct medication and is a much safer approach as well.Pharmacogenetic (PGx) testing is more important for the elderly than any other age group as older adults are at a higher risk of serious side effects relative to someone younger. Older adults taking multiple medications for varying health conditions, have a higher risk of interactions between medications when a new prescription is added to the mix. The only way to know this definitively is with a PGx Test; without testing, Physicians do not have their patient’s Genetic “Blueprint” to have a deeper understanding of how their patient will react to new medication(s).Adverse Drug Events (ADEs) accounted for over 1 million Emergency Department visits in 2019. According to the American Geriatric Society, over 90% of the elderly take at least one prescription medication and around two-thirds take 3 or more prescriptions, this leaves a huge gap for drug interactions and side effects to occur. The American Geriatrics Society publishes a tool called The AGS Beer Criteria, a database of medications that carry a high risk of side effects in the elderly. While physicians use this database for guidance, it still doesn’t provide the precision data that Pharmacogenetic (PGx) testing does. With this type of testing, physicians can prescribe medications with a higher likelihood of the medication being safe and effective while saving time, money, and reducing risk.

The Bottom Line

The process of getting a PGx test only requires a simple saliva sample. PGx testing introduces a whole new era of safer prescribing of medications. Information is power for making the right decisions, and Pharmacogenetic (PGx) testing provides that information in an easy-to-interpret manner. It can save months of trial and error prescribing and reduce the risk of serious side effects, which is good news for both Patients and Physicians.TruGenX provides pharmacogenetic (PGx) testing to medical providers nationwide. Our CLIA certified and CAP Accredited lab can help improve patient outcomes when prescribing Depression, Anxiety, or any Psychotropic Medication. With the increase in patients that are experiencing clinical depression or anxiety, a simple pharmacogenetic test can go a long way in helping your patients and creating a personalized, precise treatment plan. For more information, please contact us to get started.   
Am Fam Physician. 2020 Jan 1;101(1):56-57. BCMJ, vol. 53 , No. 47 , September 2011 , Pages 341-347 Clinical Articles Prescriber.co.uk. “Depression and antidepressant prescribing in the elderly” Penninx BW, et al. Changes in depression and physical decline in older adults: a longitudinal perspective. J Affect Dis 2000;61(1):1-12.