%0 Journal Article
%@ 1433-9285
%A Falcaro, M
%A Ben-Shlomo, Y
%A King, M
%A Freemantle, N
%A Walters, K
%D 2019
%F discovery:10073651
%J Social Psychiatry and Psychiatric Epidemiology
%K antidepressants, depression, early discontinuation, electronic health records, primary care.
%P 1545-1553
%T Factors associated with discontinuation of antidepressant treatment after a single prescription among patients aged 55 or over: evidence from English primary care
%U https://discovery.ucl.ac.uk/id/eprint/10073651/
%V 54
%X 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 agerelated 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 non-drug therapies, or  more active patient follow-up should be further considered in these circumstances.
%Z This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.