What are side effects of SSRIs in people with dementia?

Side effects of selective serotonin reuptake inhibitors (SSRIs) in people with dementia include gastrointestinal problems like loss of appetite, nausea and diarrhea in the first couple of days to weeks, although this can continue. SSRIs are typically the first-line antidepressants for treating people with dementia who also manifest depressive symptoms. If an elder is having gastrointestinal problems, it would be important to readdress whether this medication is the right one for that individual. Any of the SSRIs can also cause sedation, confusion and falls.
 
The more serious effect of SSRIs is called serotonin syndrome, which typically occurs when you combine multiple antidepressants together. This is a very dangerous condition that is characterized by confusion or altered mental status, high blood pressure, high heart rate and high fever, as well as tremors or jerking movements of the extremities. It’s very important to be aware of this potential adverse effect when thinking about an individual who is on an SSRI or maybe multiple antidepressants.
 
SSRIs can also have an effect of increasing bleeding times. This has not necessarily been borne out for individuals who are not already at risk for gastrointestinal bleeds, but for individuals who are at risk for bleeding or have already had a gastrointestinal bleed. This is important to keep in mind.