TY  - JOUR
TI  - Factors associated with discontinuation of antidepressant treatment after a single prescription among patients aged 55 or over: evidence from English primary care
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions.
SP  - 1545
ID  - discovery10073651
Y1  - 2019/12//
JF  - Social Psychiatry and Psychiatric Epidemiology
N2  - 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.
KW  - antidepressants
KW  -  depression
KW  -  early discontinuation
KW  -  electronic health records
KW  -  primary care.
VL  - 54
A1  - Falcaro, M
A1  - Ben-Shlomo, Y
A1  - King, M
A1  - Freemantle, N
A1  - Walters, K
UR  - https://doi.org/10.1007/s00127-019-01678-x
SN  - 1433-9285
EP  - 1553
AV  - public
ER  -