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Buy amlodipine 5mg /d) or clonidine (300mg/d) twice daily is the standard recommendation in older adults. The effectiveness and safety of a selective serotonin reuptake inhibitor for treatment of depression in the geriatric population is controversial. One systematic review of the use tricyclic antidepressants in geriatric populations reported that use of selective serotonin reuptake inhibitors was associated international online pharmacy germany with increased mortality from suicide (OR=7.8, 95% CI 1.3–50.3). Although this study did not show a lower risk of death from depression in geriatric patients, the risk could be significantly reduced by increasing the dose.13, 14 The association of mood disorders with a diminished risk of mortality from coronary heart disease is well established, and this fact underscores the need to reduce cardiovascular risk in geriatric patients.16 The effects of antipsychotic agents on mortality from cardiovascular disease, however, are less clear. The use of clozapine and olanzapine is associated with a decreased incidence of death from coronary heart disease compared with haloperidol and amisulpride.17, 18 A meta-analysis of prospective studies in geriatric patients showed Finasteride proscar tablet 5 mg that olanzapine had a significant protective effect against all-cause mortality.19 However, a case-control study showed no association between clozapine use and risk of death from coronary heart disease.20 The findings of these two observational studies suggest that the positive association between olanzapine use and mortality may be influenced by reverse causation, i.e, patients with a first diagnosis of cardiovascular disease may be more inclined to take olanzapine relieve depressive symptoms. We previously showed that the overall mortality risk in older individuals is substantially increased with use of either selective serotonin reuptake inhibitors and related agents or tricyclic antidepressants.21 We examined the potential protective effect of an SSRI (serotonin-norepinephrine reuptake inhibitors) against mortality from cardiovascular diseases in older patients, with a particular focus on the risk of cardiovascular death in elderly patients with comorbid major depressive disorder. Methods Study Population The present study included first cohort of buy amlodipine tablets elderly patients diagnosed with major depressive disorder as part of the Lothian Birth Cohort 1921 (LBC1921), a large, prospective cohort study designed to investigate cardiovascular risk factors in the community.22 LBC1921 is a registered Scottish cohort and has undergone institutional review. Patients aged ≥65 years who were diagnosed with major depressive disorder between 1 January 1990 and 31 December 2006 were eligible to be included as part of the present study (Figure 1). inclusion criteria did not exclude patients with a past stroke. Diagnosis of major depressive disorder is based on an interview with a psychiatrist and was confirmed by a psychiatrist or psychologist trained in clinical interview and assessment by the.
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