What is the most appropriate SSRI choice for a 64-year-old woman with generalized anxiety disorder who is on multiple medications?

Choosing the most appropriate selective serotonin reuptake inhibitor (SSRI) for a 64-year-old woman with generalized anxiety disorder who is taking multiple medications involves several considerations, particularly regarding the safety profile and potential interactions of the medication.

Escitalopram is often favored in older adults due to its favorable side effect profile and lower potential for drug-drug interactions compared to other SSRIs. It is well-tolerated and has been shown to be effective in treating anxiety disorders. Additionally, escitalopram tends to cause less sedation and may have a lower risk of causing issues such as weight gain or sexual side effects, which can be particularly important for older patients who may already be experiencing these problems due to age or other medications.

In contrast, other SSRIs like fluoxetine and paroxetine may have a higher likelihood of interactions with other medications, which is a crucial factor for this patient given her multiple medications. Paroxetine, in particular, is known for its sedative effects and anticholinergic properties, which can be problematic in older adults. Sertraline is effective but also carries a risk of drug interactions, particularly with certain medications commonly prescribed to older adults.

Overall, escitalopram stands out as the most appropriate choice for this patient