US Pharm. 2019;44(11):5.

According to new research led by the University of East Anglia (UEA) in the United Kingdom, the proportion of people older than age 65 years taking antidepressant medications has more than doubled in 2 decades. Even with an increase in antidepressant use, however, there has been little change in the number of older persons diagnosed with depression.

The results were based on findings of the Cognitive Function and Ageing Studies, conducted between 1991 and 1993 and 2008 and 2011, published in the British Journal of Psychiatry. Scientists interviewed more than 15,000 subjects over age 65 years in England and Wales to determine whether the prevalence of depression and antidepressant use is changing.

Lead author Professor Antony Arthur, from UEA’s School of Health Sciences, said, “Depression is a leading cause of poor quality of life worldwide, and we know that older people may be less likely than other age groups to go to their GP with symptoms of depression.

“Until now, little was known about how the relationship between the prevalence of depression and antidepressant use among older people has changed over time. The Cognitive Function and Ageing Studies led by the University of Cambridge have the ability to examine changes in the health needs of older people across generations based on random sampling and diagnostic methods held constant over time.”

The study’s lead investigator, Professor Carol Brayne, director of the Cambridge Institute of Public Health, said, “Our research has previously shown a dramatic age-for-age drop in dementia occurrence across generations. This new work reveals that depression has not shown the same reduction even in the presence of dramatically increased prescribing, itself not without concern given potential adverse effects we have also shown that are associated with polypharmacy.”

The studies produced the following key findings: The proportion of older people receiving antidepressant medication more than doubled over 2 decades; the estimated prevalence of depression among those older than age 65 years in the early 1990s was 7.9%, compared with 6.8% 20 years later; depression and antidepressant use were more common in women than men; depression was associated with living in a more deprived area; the proportion of over-65s living in nursing homes declined, but prevalence of depression in nursing homes was unchanged, affecting around one in 10 residents; and most people with case-level depression were not taking antidepressants, while most of those taking antidepressants did not have depression.

In this issue, which focuses on mental health, learn about pharmacologic advances in treatment-resistant depression in the CE cover story by Kimberly E. Ng, PharmD, BCPS, and Farah Khorassani, PharmD, BCPS, BCPP. As the authors report, the available options now include recently approved esketamine, which patients self-administer in a clinic-based setting.

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