Which antidepressant is explicitly listed among potentially inappropriate medications to be used with caution in older adults?

• A. Fluoxetine
• B. Sertraline
• C. Mirtazapine
• D. Citalopram

Answer: (C)

Beers Criteria flags certain antidepressants because their side effects can pose particular risks for older adults. Mirtazapine stands out as something to use with caution in seniors because its sedating effects, potential for weight gain, and risk of orthostatic hypotension can lead to falls, confusion, and functional decline. In contrast, while fluoxetine and sertraline are SSRIs that require monitoring for issues like hyponatremia, they aren’t singled out in the same explicit “use with caution” way within this context. Citalopram does have concerns—specifically QT prolongation at higher doses in older patients—but the item here highlights mirtazapine as the antidepressant listed for cautious use due to its particular risk profile in the elderly.