Natural history of pharmacotherapy of older depressed community residents - The MRC-ALPHA Study

Background Depression in older people is common and has a high mortality, b ut effective treatments exist. Aims To describe drug prescribing in older community residents in relation to depression status. Method The MRC-ALPHA community cohort aged 65 and over were interviewed usi ng the Geriatric Mental State examination drug data collected at index inte rview and at two and four years. Results Antidepressants were used by 10.9% of the depressed population. Ben zodiazepines were used frequently. Of the antidepressant users, 59.6% took low-dose antidepressants for two years, had a poor outcome and few drug cha nges. Conclusions Trends of increasing antidepressant use have cost implications for primary care groups. Benzodiazepines may be mis-prescribed for treatmen t of depressive symptoms. Antidepressant users have poor outcome and follow -up. Declaration of interest The ALPHA study was funded by the Medical Research Council and the Department of Health. Collection and coding of medication d ata were supported by grants from the Liverpool Family Health Services Auth ority. Analyses were supported by a grant from Lilly Industries pie. No con ditions whatsoever were attached to the award from Lilly Industries and the company took no part in the collection, analyses and interpretation of the data.