More Elderly Prescribed Antidepressants

Reaching old age shouldn’t be associated with feeling depressed but a new study has found that not enough doctors properly assess or treat patients over the age of 65 for mental health problems like depression.  And when they are treated, it’s more often with antidepressants rather than a referral for talk therapy, which has been found to be a helpful treatment for seniors with symptoms of depression. 

According to a recent report in The Guardian, 87 percent of patients over the age of 75 suffering from depression are treated with medication.  A study, published in the British Journal of General Practice found that nearly 4 in 10 seniors over 75 show some symptoms of depression and yet family doctors are not often talking with their patients about the condition or recommending treatment by a therapist.  In fact, older adults past 65 are twice as likely as younger people to be treated with antidepressants and only a small percentage are referred to talk therapy. 

The stigma of mental health problems may be greater in the older population and physicians focusing on physical health often fail to screen for depression or other mental health problems common in older age.  With a growing senior population, there needs to be greater awareness, education and access to therapy for depression before rushing to prescribe drugs.  

According to an article in the BC Medical Journal, depression is a common but undertreated condition in the elderly population.  Because many older adults take multiple prescriptions for chronic illnesses, it’s important to check with a pharmacist for any potential drug interactions before adding a new medication to a regime.  And conditions like dementia, Parkinson’s disease or cardiovascular disease may be worsened by some antidepressant drugs. 

Risk Factors for Elderly Depression

  • Female sex
  • Widowed or divorced status
  • Previous depression
  • Brain changes due to vascular problems
  • Major physical and chronic disabling illnesses
  • Polypharmacy
  • Excessive alcohol use
  • Social disadvantage and low social support
  • Caregiving responsibilities for a person with a major disease (e.g., de­men­tia)
  • Personality type (e.g., relationship or dependence problems)

Precipitating risk factors

  • Recent bereavement
  • Move from home to another place (e.g., nursing home)
  • Adverse life events (e.g., loss, separation, financial crisis)
  • Chronic stress caused by declining health, family, or marital problems
  • Social isolation
  • Persistent sleep difficulties

Source:  BDMJ Geriatric Depression