Natural history of pharmacotherapy of older depressed community residents

BACKGROUND: Depression in older people is common and has a high mortality, but effective treatments exist. AIMS: To describe drug prescribing in older community residents in relation to depression status. METHOD: The MRC-ALPHA community cohort aged 65 and over were interviewed using the Geriatric Mental State examination drug data collected at index interview and at two and four years. RESULTS: Antidepressants were used by 10.9% of the depressed population. Benzodiazepines were used frequently. Of the antidepressant users, 59.6% took low-dose antidepressants for two years, had a poor outcome and few drug changes. CONCLUSIONS: Trends of increasing antidepressant use have cost implications for primary care groups. Benzodiazepines may be mis-prescribed for treatment of depressive symptoms. Antidepressant users have poor outcome and follow-up.