Table 1.
Evidence from the scientific literature about age-related reduction in systemic clearance of antidepressants
| Class/Agent | Age-related reduction in clearance | Reference |
|---|---|---|
| MAOI | ||
| Isocarboxazid | N/A | |
| Phenelzine | N/A | |
| Selegiline | N/A | |
| Tranylcypromine | N/A | |
| Other Antidepressants | ||
| Bupropion | Yes | [27] |
| Mirtazapine | N/A | |
| Nefazodone | N/A | |
| Methylphenidate | N/A | |
| Trazodone | Yes | [28,29] |
| Vilazodone | N/A | |
| SNRI | ||
| Desvenlafaxine | Yes | [30] |
| Duloxetine | N/A | |
| Venlafaxine | Yes+ | [30] |
| SSRI | ||
| Citalopram | Yes | [31–33] |
| Escitalopram | Yes | [31, 32] |
| Fluoxetine | N/A | |
| Paroxetine | N/A | |
| Sertraline | Yes | [34] |
| Tetracyclics | ||
| Amoxapine | N/A | |
| Maprotiline | No | [35] |
| Trimipramine | N/A | |
| TCA | ||
| Amitriptyline | Yes | [36–38] |
| Desipramine | No | [39] |
| Doxepin | Yes | [40,41] |
| Imipramine | Yes | [35,39,42] |
| Nortriptyline | Yes | [43,44] |
*
renal clearance may be impaired with age; avoid use in creatinine clearance < 30ml/minute
+
men only; dose reduction recommended with reduced creatinine clearance
Abbreviations: MAOI=monamine oxidase inhibitor; NA= none available; SNRI=selective norepinephrine reuptake inhibitor, SSRI= selective serotonin reuptake inhibitor; TCA=tricyclic antidepressant