Factors associated with discontinuation of antidepressant treatment after a single prescription among patients aged 55 or over: evidence from English primary care

Milena Falcaro, Yoav Ben-Shlomo, Michael King, Nick Freemantle, Kate Walters

Research output: Contribution to journalArticle (Academic Journal)

1 Citation (Scopus)
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Abstract

Purpose: Antidepressants are frequently prescribed to older people with depression but little is known on predictors of discontinuation in this population. We therefore investigated factors associated with early discontinuation of antidepressants in older adults with new diagnoses or symptoms of depression in English primary care.

Methods: Data from a nationally representative cohort of patients aged 55 and over were used to evaluate the association between discontinuation of antidepressant medication after a single prescription and potential explanatory variables, including socio-demographic factors, polypharmacy and age-related problems such as dementia.

Results: Overall, during the study period we observed 34,715 new courses of antidepressant treatment initiated after recorded symptoms or diagnoses of depression. Antidepressant discontinuation after a single prescription was more common in people with depressive symptoms (32%) than in those with diagnosed depression (21.6%). In those diagnosed with depression and in women with depressive symptoms we found that, after adjusting for confounders, the odds of early discontinuation significantly increased after age 65 with a peak at around age 80 and then either levelled or reduced thereafter. Early discontinuation was also significantly less common in people with dementia and in those with diagnosed depression living in more rural areas.

Conclusions: Early discontinuation of antidepressants increases in the post retirement years and is higher in those with no formal diagnosis of depression, those without dementia and those with diagnosed depression living in urban areas. Alternative treatment strategies, such as nondrug therapies, or more active patient follow-up should be further considered in these circumstances.
Original languageEnglish
Pages (from-to)1545-1553
Number of pages9
JournalSocial Psychiatry and Psychiatric Epidemiology
Volume54
Issue number12
Early online date19 Mar 2019
DOIs
Publication statusPublished - 1 Dec 2019

Keywords

  • antidepressants
  • primary care
  • electronic health records
  • early discontinuation
  • depression

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