Comorbidity of chronic disease and potential treatment conflicts in older people dispensed antidepressants

Age Ageing. 2010 Jul;39(4):488-94. doi: 10.1093/ageing/afq055. Epub 2010 May 27.


Objectives: the study aimed to examine the prevalence of comorbidity, the prescribing of potentially inappropriate medications and treatment conflicts in a large sample of older people who have been dispensed an antidepressant medicine.

Methods: a cross-sectional study of administrative claims data from the Department of Veterans' Affairs, Australia, 1 April-31 July 2007, of veterans aged > or =65 years was conducted. Comorbidities determined using the pharmaceutical-based comorbidity index, Rx-Risk-V. Concomitant medicines that may be potentially inappropriate for patients with depression and areas of treatment conflicts were determined from Australian clinical guidelines or reference compendia.

Results: a total of 39,695 subjects were included, with a median of 5 comorbid conditions (inter-quartile range 3-6). Ninety percent of medicine use was attributed to the treatment of comorbid conditions. Eighty-seven percent of the study cohort was identified as having at least one comorbid condition that may cause a potential treatment conflict when an antidepressant is used. Those conditions of most concern included cardiovascular diseases, anxiety disorders, arthritis or pain management and osteoporosis.

Conclusion: we observed a high level of potentially inappropriate prescribing and treatment conflicts that may arise when caring for older patients dispensed an antidepressant with comorbidity. These have the potential to place a large number of older people with depression at increased risk for adverse events.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / adverse effects
  • Antidepressive Agents / therapeutic use*
  • Anxiety / drug therapy
  • Arthritis / drug therapy
  • Australia / epidemiology
  • Cardiovascular Diseases / drug therapy
  • Chronic Disease
  • Comorbidity
  • Cross-Sectional Studies
  • Depression / drug therapy*
  • Drug Incompatibility*
  • Female
  • Humans
  • Male
  • Medication Errors
  • Osteoporosis / drug therapy
  • Pain / drug therapy
  • Practice Guidelines as Topic


  • Antidepressive Agents