Which medication for depressive disorder can be particularly dangerous if misused in a 70-year-old woman?

Nortriptyline is a tricyclic antidepressant that can pose significant risks if misused, particularly in older adults. The pharmacological profile of nortriptyline includes a range of side effects that can be more pronounced in the elderly, such as increased sedation, orthostatic hypotension, and anticholinergic effects. These effects can lead to dangerous situations, such as falls or cardiovascular issues.

Additionally, tricyclic antidepressants like nortriptyline can be lethal in overdose scenarios due to their potential to cause arrhythmias and other serious complications. Older adults, including a 70-year-old woman, may already have comorbidities or be taking other medications that heighten the risks associated with nortriptyline.

While other medications listed can also carry risks, the combination of nortriptyline's side effect profile and the potential consequences of misuse makes it particularly concerning in the context of an older population.