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1 Introduction Selective serotonin reuptake inhibitors (SSRIs) increase extracellular serotonin levels by inhibiting the neurotransmitters reuptake by synaptic cells, thereby increasing the binding and activation of postsynaptic receptors

The potential molecular mechanisms underlying these effects included disturbances in redox homeostasis (as evidence by the enhanced production of ROS and reactive nitrogen species), failure of enzymatic and nonenzymatic cytoprotective mechanisms involving the glutathione system as well as nuclear factor kappa B (NF-B) and fibroblast growth factor 2-mediated pathways, and impaired mitochondrial function

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Heres what we recommend for elderly patients: Start with 1000 mcg of vitamin B12 weekly for 4-6 weeks Then, give 1000 mcg every 1-3 months, depending on how theyre doing Keep an eye on their vitamin B12 levels, blood counts, and brain function A study in the Journal of Gerontology stressed the need for B12 in older adults