Factors associated with changes in antidepressant use in a community-dwelling elderly cohort: the Three-City Study

Abstract

This study aimed to examine changes in antidepressant use in an elderly population over a 2-year period and to determine which factors could predict these changes. This longitudinal study was conducted in 8,061 French community-dwelling subjects aged 65 years and over. At each wave, data on antidepressant use and general health status were collected and depressive symptoms were evaluated using a standardized instrument. Logistic regression models were used to identify baseline predictors of subsequent changes in antidepressant use. Prevalence of antidepressant use increased from 7.0% at baseline to 8.6% at 2-year follow-up. Selective serotonin reuptake inhibitors (SSRI) accounted for the main part of this increase. Four percent of the baseline nonusers took antidepressants 2 years later. This change was significantly associated with female gender, older age, higher education level, elevated depressive symptoms at baseline, history of major depression, poor self-perceived health, high consumption of nonpsychotropic drugs and cognitive impairment (in particular dementia). Approximately 5% of the elderly population was treated with antidepressants at both examinations, and most of them reported using the same class of antidepressant. Antidepressant withdrawal occurred in only 30% of antidepressant users; we did not find any factor significantly associated with termination of antidepressant use. In this large elderly population, the proportion of antidepressant users increased by 23% over a 2-year period. Increasing use was found in all age groups. Our data suggested that many elderly people are chronic users of antidepressants independently of their depression status.