Fluoxetine in Elderly Patients: Is There Cause for Concern?

Objective To assess whether fluoxetine use is associated with significant weight loss or other side effects in depressed elderly patients with concomitant medical illness. Design A retrospective chart review. Setting A tertiary care VA hospital. Patients Five groups of outpatients were studied: (1) patients greater than 75 years old receiving fluoxetine (n = 15); (2) patients 60 to 71 years old receiving fluoxetine (n = 20); (3) patients greater than 75 years old receiving nortryptiline or desipramine (n = 20); (4) patients greater than 75 years old with a history of depression but on no antidepressant medication (n = 20); and (5) patients greater than 75 years old with no history of depression (n = 28). Measurements Mortality, change in weight, reports of anorexia or nausea, and serum sodium and glucose measurements. Main Results Patients greater than 75 years of age taking fluoxetine experienced significantly greater weight loss (average 4.6 kilograms, P = 0.0062) than the other groups. Both groups of patients taking fluoxetine were significantly more likely to report nausea (P = 0.0095) and anorexia (P = 0.0009). No significant differences were noted in mortality or the frequency of hypoglycemia or hyponatremia between groups. Conclusion The frequency and degree of weight loss noted here in medically ill elderly receiving fluoxetine warrants further investigation.