What is a common strategy to minimize side effects in older adults prescribed a selective serotonin reuptake inhibitor?

Prescribing a low dose initially and adopting a "start low and go slow" approach is particularly effective for minimizing side effects in older adults who are prescribed a selective serotonin reuptake inhibitor (SSRI). This strategy is essential because older adults often have varying pharmacokinetics due to factors such as altered metabolism, comorbidities, and polypharmacy. Starting at a lower dose allows healthcare providers to assess the patient’s tolerance to the medication while minimizing the risk of adverse reactions.

By gradually increasing the dose, clinicians can monitor for side effects and adjust treatment based on the individual patient’s response. This careful titration is particularly aimed at ensuring that the benefits of the medication are achieved without overwhelming the patient with adverse effects, which can be more pronounced in the elderly population.

In contrast, prescribing a regular or standard dose immediately may lead to a higher incidence of side effects since older adults might not tolerate these doses as well as younger patients. Rapidly increasing the dose until symptoms improve could result in significant distress and increase the likelihood of side effects. Combining the SSRI with other medications to manage side effects may introduce further complexities and risks, especially considering potential drug interactions and the overall burden of polypharmacy in older populations.