So we talked about this as far as we knew that the SSRIs
can sometimes mess with your sleep and give you insomnia.
TCAs can cause a sedation. This may not be acceptable to a patient during the day.
It depends on the level or intensity of the sedation.
Now with our elderly clients, they really have to watch the dosage with elderly clients
because this drug can cause confusion particularly with the elderly clients
so sometimes they're on half the dose that we would put a middle-aged adult on.
Let's talk about cardiovascular, orthstatic hypotension is a problem with this medication.
Some people more than others but it can cause orthostatic hypotension
so that means when I'm going from lying to sitting or sitting to standing,
if I do it too quickly, I'll get really dizzy and be at a risk for falls.
So if I'm an older person, I'm at risk for confusion and orthostatic hypotension.
Yeah, this is gonna be a really tricky drug to have with an elderly person.
In addition to that, when we're thinking about the cardiovascular system,
you can have some arrythmias and cardiac toxicity.
It means it's gonna be really hard on my heart.
Old, risk for falls, cardiac arrhythmias, cardiac toxicity,
might not be the best option depending on how the patient is doing particularly with an elderly patient.
Now this, like a lot of the antidepressants, can -- is known to cause weight gain.
It also has the same kind of anticholinergic effects we talked about.
So anticholinergic, dry mouth, constipation, blurred vision from the dry eyes,
so dry eye, dry mouth, urinary retention might also be an issue,
and you can end up with constipation because of these medications.
So sometimes, taking a TCA at bedtime is a good idea.
Now looking at all these up here, besides the anticholinergic effects,
what else would make taking it at bedtime a good idea?
Right, the sedation.
So it might be easier for the patient's daily life to deal
with the sedation if they take it at bedtime.