Case-report and Review of Selective Serotonin Reuptake Inhibitors-induced Delirium in Older Adults

Abstract

Introduction

Selective serotonin reuptake inhibitors (SSRIs) are the most widely prescribed antidepressants with generally fewer side effects than most other types of antidepressants. However, in frail elderly, the use of SSRIs was anecdotally reported as a potential cause of a delirium.

Objectives

To present a case of citalopram-induced delirium in an older adult diagnosed with late-life depression.

Aims

To review available literature on SSRI-induced delirium.

Methods

A case report is presented and discussed, followed by a literature review.

Results

Seven published cases of SSRI-induced delirium in older adults (> 60 years) were found while searching through Pubmed and Embase. Our case of a 75-year-old female is also included in this report. This patient was ambulatory treated with citalopram 20 mg per os against depressive symptoms and she developed a delirium four days after the initiation of the therapy. Blood tests were normal and CT scan showed no significant findings. No other medical evidence was found that could explain her delirium. Her symptoms finally resolved after discontinuation of citalopram.

Conclusion

The on- and off-treatment side-effect correlation by a segregate oral use of citalopram strongly suggests that SSRIs may have the potential to cause a delirium, especially in frail elderly. Further research on this topic is needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.