Increased Antidepressant Use Does Not Decrease Depression Prevalence in Older Adults

The use of antidepressants has risen quickly among older adults but the rate of depressive symptoms in this population has not declined as a result.

Peter Simons
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Antidepressant use has more than doubled in older adults since 1990, according to a new study in The British Journal of Psychiatry. However, the increase in the use of the drugs has not resulted in any decrease in depression, the prevalence of which stayed the same over that time.

Those in care homes fared the worst: although again, the prevalence of depression stayed the same, their antidepressant use increased fourfold, from 7.4% in 1990 to 29.2% in 2011. The authors write:

“Over two decades, substantial increases in access to antidepressant medication do not appear to be associated with change in prevalence of late-life depression. The natural history of treated and untreated depression, particularly for older people, remains poorly understood.”

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The research was conducted by the Cognitive Function and Ageing Studies Collaboration (CFAS) in the UK, and the study was led by Anthony Arthur at the University of East Anglia. The CFAS data included diagnoses and antidepressant use for several thousand adults 65 and older. The data was collected first between 1990-1993, and the second collection of data happened from 2008-2011. The current study compares the early 1990s data to the late 2000s data.

Antidepressant use in this population more than doubled—from 4% in the early 1990s to 10.7% in the late 2000s.

The researchers write that the increase in antidepressant use may be due to a number of factors, including overdiagnosis, prescribing for off-label use, or better recognition of depression. 

In the late 2000s dataset, about 82% of those receiving antidepressants did not have a diagnosis of depression. In the early 1990s data, 64% of those receiving antidepressants did not have the diagnosis. 

At both time points, about twice as many women as men were diagnosed with depression and, similarly, about twice as many received an antidepressant, both with and without the diagnosis of depression.

The study was observational in nature, so the researchers caution that no causal conclusions can be drawn from their data. They encourage more research on the treatment of depression, especially in older adults.

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Arthur, A., Savva, G. M., Barnes, L. E., Borjian-Boroojeny, A., Dening, T., Jagger, C., . . . & the Cognitive Function and Ageing Studies Collaboration. (2019). Changing prevalence and treatment of depression among older people over two decades. The British Journal of Psychiatry. doi: 10.1192/bjp.2019.193 (Link)

4 COMMENTS

  1. “depression”. The label given to people with real physical disabilities. Real physical pain does not make one happy, causes sleep loss, etc. And the pills will not take the pain away, which is of course the reason for lack of ‘joy’, ability to move around, appetite, sleep. It is also not happy making to be in a coral built for old people. Often they are physically ill, dementia and none of those, plus the environment are happy making. There are scores of people put on ‘serotonin’ for something psychiatry and doctors got together on and labeled it as a “co-morbid condition”, called “depression”. These pills might work for some, yet I do not know who they are. Since ‘depression’ can wax and wane, perhaps when you feel better, it’s not the drug. I know people on these drugs and I see no difference.

  2. “They encourage more research on the treatment of depression, especially in older adults.” Always calling for more research – more money, more money, more money, give us more money for research! How about instead, finally confessing that the antidepressants are not effective for any age group. But the antidepressants can cause great harm. How long do the lunatics within the “mental health” industry need to keep researching into their “invalid” DSM disorders?

    https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml

    Depressing events can cause depression, but “chemical imbalances” in people’s brains do not, that’s “bullsh-t.”

    https://www.wired.com/2010/12/ff_dsmv/

    Wake up “mental health” workers, stop defaming and neurotoxic poisoning other innocent human beings for profit.