The older we get, the more likely we are to develop serious health conditions, such as diabetes or heart disease. About 25 percent of older adults with such chronic illnesses also suffer from depression. As a result, adults 65 and older may take five or more medications at any time. In addition to treating different conditions, sometimes physicians add a second (or third) drug to increase the effectiveness of another medication or to help treat medication side effects.

There's no question that antidepressants can be a tremendous help to depressed seniors. However, antidepressants, in combination with other medications, can cause adverse reactions, or drug-drug interactions. These drug interactions can be mild, such as insomnia or dizziness, or, although rare, can be serious. Because of these reactions, many seniors decrease the prescribed dose of, or completely stop taking, their antidepressants.

Adding medications on top of other medications can change the absorption, distribution, metabolism, or ability of the liver to excrete the drugs. When you consider all the medications a person might take, it's nearly impossible to identify the interactions of all the potential combinations.

Experts believe up to half of adverse drug interactions can be prevented if physicians carefully consider possible risk factors, such as age, other illnesses present, and known drug-drug interactions. Your physician should start your antidepressant at the lowest dose possible, and increase it gradually as needed.

If you take antidepressants, here are a few suggestions for minimizing adverse medication reactions.

  • Tell your physician about all prescription and non-prescription medications you are taking. This includes vitamins and supplements. Non-prescription substances can also cause harmful interactions when mixed with prescription drugs.
  • Limit your exposure to different physicians, if possible. The more physicians you see, the more complicated it can be for any one doctor to keep track of all your medications.
  • Use one pharmacy to fill your prescriptions. Your pharmacists may notice potentially harmful combinations and can bring them to your attention.
  • Listen to your body. If you notice any side effects or changes in the way you feel, tell your physician right away. Ask your physician if there's another medication to treat your depression or other condition. Some drugs work on different metabolic pathways, which may reduce the potential for negative interaction.
  • It's important to take an active role in your own care, or to enlist the help of a trusted family member who can help you prevent your depression treatment from causing additional health problems.


Richards, J. Brent MD, Papaioannou, Alexandra MD, MSc, Adachi, Jonathan D. MD, Joseph, Lawrence PhD, Whitson, Heather E. MD,  Prior, Jerilyn C. MD, and Goltzman, David MD. "Effect of Selective Serotonin Reuptake Inhibitors on the Risk of Fracture." Archives of Internal Medicine 167 (2007): 188-194. Web .