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October 2019

Number of over-65s on antidepressants doubles in 20 years

The number of older people taking antidepressants has more than doubled over the last two decades, according to new research in the British Journal of Psychiatry, but the prevalence of depression in this group appears to have declined over the same period.

The latest Cognitive Function and Ageing Study (CFAS II) compared prevalence of confirmed depression in people over 65 years in the late 2000s with rates found in the first CFAS report in the early 1990s – and found a decrease in prevalence of around 20% (from 7.9% to 6.8%). But the percentage of over-65s on antidepressants has increased from 4.2% to 10.7%.

More than 7,500 people, living independently or in care homes, were interviewed for the study. The proportion of people prescribed antidepressant medication in CFAS II was more than double that in CFAS I, and among those living in care homes it was four time higher in CFAS II than in the first report.

Worryingly, the researchers found that only a minority of people with confirmed depression were taking antidepressant medication, and most of those taking antidepressants did not have severe depression, although they may have had subclinical depression or low mood.

This study echoes other data from NHS Digital earlier this year, which showed antidepressant prescribing in the UK doubled between 2007 and 2017: in England in 2018 there were over 70 million prescription for antidepressants, a 5% increase on the previous year. These changes in prescribing have been accompanied by a smaller increase in the prevalence of depression among adults and children.

Study author Professor Anthony Arthur said it was unclear whether the increases in treatment were a reflection of ‘overtreatment, better recognition and prescribing or the prescribing of antidepressant medication for conditions other than depression’.

Arthur A, et al. Br J Psychiat 2019. ePub 7 October 2019. doi: 10.1192/bjp.2019.193