Can selective serotonin inhibitor drugs in elderly patients in nursing homes be reduced?

Scand J Prim Health Care. 2007 Mar;25(1):3-8. doi: 10.1080/02813430600958427.

Abstract

Objective: To investigate whether treatment with selective serotonin reuptake inhibitors (SSRIs) could be withdrawn for elderly residents who had been on treatment for at least one year and to evaluate a method for systematic drug review.

Design: Open, prospective, interventional study.

Setting: Four counties in Sweden.

Subjects: Elderly residents at 19 nursing homes, with ongoing treatment with SSRIs for more than one year.

Main outcome measures: Clinical evaluation, registration of drugs used and rating with Montgomery-Asberg Depression Rating Scale (MADRS). A semi-structured telephone interview with 15 participating physicians and 19 nurses.

Results: About one-third of all 822 residents in the nursing homes had ongoing antidepressant treatment, predominantly with SSRIs; 75% of them had been treated with SSRIs for at least one year and 119 (60%) of these were considered eligible for the study. The intervention was judged successful in 52% of these residents of whom 88% had a MADRS rating of less than 20 points. The GPs and the nurses experienced the method as practicable.

Conclusions: Withdrawal of SSRI treatment was successful in the majority of cases. The MADRS may be a valuable addition to clinical evaluation when deciding whether to end or continue SSRI treatment.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Depression / diagnosis
  • Depression / drug therapy
  • Drug Utilization Review / methods*
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Nursing Homes
  • Polypharmacy
  • Practice Patterns, Physicians'
  • Prospective Studies
  • Serotonin Uptake Inhibitors / administration & dosage*
  • Serotonin Uptake Inhibitors / adverse effects

Substances

  • Serotonin Uptake Inhibitors