Which antidepressant class is among the three most common delirium precipitants?

• A. Tricyclic antidepressants
• B. SSRIs
• C. SNRIs
• D. MAO inhibitors

Answer: (A)

Delirium is often triggered by medicines with strong anticholinergic effects or sedative properties, and this risk is especially high in older adults. Among antidepressants, tricyclic antidepressants have notable anticholinergic activity, which can lead to confusion, disorientation, and delirium in vulnerable patients. In comparison, selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors have less anticholinergic burden, so they are less likely to precipitate delirium. Monoamine oxidase inhibitors carry other significant risks (like hypertensive crises and serotonin syndrome) but are not typically among the most common delirium precipitants. Therefore, the antidepressant class most commonly linked to delirium precipitants is the tricyclic antidepressants.