Antidepressants for Seniors: Safe Options, Side Effects, and What Works Best

When antidepressants for seniors, medications used to treat depression in older adults, often requiring special care due to age-related changes in metabolism and coexisting health conditions. Also known as geriatric antidepressants, they’re not just scaled-down versions of drugs for younger people—what works for a 30-year-old might be risky for a 70-year-old. Depression in older adults isn’t normal aging. It’s a medical issue, often overlooked because symptoms look like fatigue, memory loss, or irritability. But left untreated, it worsens physical health, increases fall risk, and can shorten life.

Not all antidepressants are created equal for seniors. SSRIs, selective serotonin reuptake inhibitors, a class of antidepressants with fewer side effects than older drugs, often preferred for older patients. Also known as newer antidepressants, they like sertraline and escitalopram are commonly chosen because they’re less likely to cause dizziness, dry mouth, or heart rhythm problems. On the other hand, tricyclic antidepressants, an older class of depression meds that affect multiple brain chemicals but carry higher risks for seniors, including confusion and falls. Also known as TCAs, they like amitriptyline and dosulepin—mentioned in several posts here—are effective but often avoided unless other options fail. Why? They can mess with blood pressure, make you drowsy, or even cause urinary retention, which is already common in older men.

Seniors often take five or more meds for diabetes, blood pressure, or arthritis. That’s why drug interactions matter more than ever. An antidepressant might make a blood thinner too strong, or combine with a painkiller to cause dangerous serotonin buildup. That’s why doctors start low and go slow—sometimes with half the usual dose. And it’s not just about the pill. Therapy, movement, sunlight, and social connection all play a role. The best antidepressant for a senior isn’t always the one with the strongest effect—it’s the one they can actually tolerate and stick with.

What you’ll find below are real comparisons: how Endep stacks up against newer options, how Prothiaden compares to alternatives, and why Zoloft keeps showing up as a go-to for older patients. These aren’t theory pieces—they’re practical, side-by-side breakdowns written for people who need to make smart choices, not just read about them. Whether you’re helping a parent, a partner, or yourself, this collection gives you the facts you need to talk to a doctor with confidence.