Mirtazapine
[Remeron] Ideal for elderly and depression with GI problems, insomnia, anxiety.
Elderly-Preferred
Suvorexant
[$ Belsomra] Orexin antagonist, improves next-day congnition, low abuse potential, low fall risk. Ideal for elderly. However, daridorexant and lemborexant more effective.
Lemborexant
[$ Dayvigo] Orexin antagonist, improves next-day cognition, low abuse potential, low fall risk. Ideal for elderly.
Daridorexant
[$ Quviviq] Orexin antagonist, improves next-day cognition, low abuse potential, low fall risk. Ideal for elderly.
Ramelteon
[Rozerem] Safe hypnotic that may improve depression in bipolar disorder. Think of it as a potent melatonin.
Methylphenidate
First-line stimulant (more neuroprotective and safer for mental health than amphetamine). May help apathy in old age but not for depression.