General practitioners preferred prescribing newer antidepressants, particularly SSRIs, for late-life depression, while older GPs were more likely to prescribe tricyclic antidepressants.
Cross-Sectional (n=330)
Yes
What are the attitudes and prescribing practices of general practitioners regarding antidepressant use for late-life depression?
General practitioners show a preference for prescribing SSRIs over older antidepressants for late-life depression, though older and less psychiatrically trained GPs may benefit from further training.
BACKGROUND: Most depression in older people is managed in primary care settings but can be difficult to diagnose and is often under-treated. This study examined the attitudes and practice of general practitioners in the treatment of late-life depression using antidepressant medication. METHOD: Three hundred and thirty general practitioners in 116 general practices within the Nottingham Health Authority were surveyed. Their responses to a series of attitude statements and clinical vignettes regarding antidepressant prescribing were assessed. RESULTS: Analysis of vignettes showed newer antidepressants to be prescribed much more frequently than older antidepressants, with a substantial increase in the use of SSRIs compared to the results of previous research. Older general practitioners and those who had been in practice for longer were more likely to prescribe tricyclic antidepressants. They were also more likely to identify a need for extra training in treating old age depression, as were those GPs without previous psychiatric training. However, most GPs were confident in treating depression in the elderly although younger GPs were the most confident. CONCLUSIONS: Selective Serotonin Re-Uptake Inhibitors are the preferred drugs in treating certain problematic cases of late-life depression. These results suggest there may be a greater propensity for GPs to prescribe SSRIs although further research is needed to clarify whether this finding can be generalised beyond this study. Most general practitioners felt confident in treating late-life depression, but older doctors, those who had been practising for longer and those without previous psychiatric training, may benefit most from further training.
Rothera et al. (Mon,) conducted a cross-sectional in Late-life depression (n=330). Survey of attitudes and clinical vignettes was evaluated on Responses to attitude statements and clinical vignettes regarding antidepressant prescribing. General practitioners preferred prescribing newer antidepressants, particularly SSRIs, for late-life depression, while older GPs were more likely to prescribe tricyclic antidepressants.