Antidepressant prescription patterns and associated factors among the elderly with psychiatric illnesses

Abstract

Objectives: The prevalence of antidepressant prescriptions for elder patients with psychiatric illnesses is increasing over the world. No studies exist to focus on the prescription patterns and trend of antidepressant use for the elderly in psychiatric hospitals of Taiwan. Methods: In this retrospective study for all outpatients equal or over 65 years of age in a psychiatric hospital, we collected related study variables from the study hospital from 2006 to 2015. Reviewing data of the electronic medical information system, we extracted both patients' demographic data (information for sex, age, and insurance status) and their clinical variables (psychiatric diagnosis and prescriptions of antidepressants). Results: In this study, we found that the proportion of antidepressant prescriptions was increased at around 7.85% (from 39.79% in 2006 to 42.92% in 2015, p < 0.001). We also found that the proportions of some antidepressants (selective serotonin reuptake inhibitors, serotonin–norepinephrine reuptake inhibitors, norepinephrine–dopamine reuptake inhibitors, and noradrenergic and specific serotonergic antidepressants) were increased, but some antidepressants (tricyclic antidepressants [TCAs] as well as serotonin antagonist and reuptake inhibitors) were decreased over the study period. TCAs were decreased in their use from 2.52% to 1.72%. The logistic regression showed that female gender, younger age, affective disorders, and neurotic disorders were found to be associated with a higher chance of antidepressant prescriptions. Conclusion: The result of this study is similar to the conclusion of other previous studies. But the decreased trend of TCA prescriptions is different from that in other studies. Future research should focus on the treatment indications, associated factors, off-label use, adverse effects, and safety of antidepressants in the elderly population.

Keywords

• citalopram
• elder patients
• geriatric patients
• mirtazapine