Abstract
Answer C. Start mirtazapine
For patients on warfarin, heparin or non-steroidal anti-inflammatory drugs, mirtazapine is the preferable option owing to the gastrointestinal bleeding risk with selective serotonin reuptake inhibitors. Mirtazapine is also particularly helpful where insomnia, low weight and poor appetite are predominant symptoms, as this medication has side effects of increasing appetite and causing drowsiness. Tricyclic antidepressants are not recommended first line in older adults owing to their risk of arrythmias and anticholinergic side effects.
InnovAiT article: Depression in older adults. DOI: 10.1177/17557380211052072.