Antidepressant drug prescribing among elderly subjects: a population-based study.
BACKGROUND
The patterns of antidepressant drug prescribing have rarely been studied in large and geographically defined populations of elderly subjects. In the present study we examined the prevalence and distribution of antidepressant prescribing in Lombardy, a northern Italy region with more than one and a half million elderly inhabitants.


METHODS
We used the Regional Administrative Database of Lombardy. This database includes all prescriptions reimbursed by the National Health System in the population living in this region. All antidepressant prescriptions dispensed to subjects aged 65 years or above during 2001 were extracted and prevalence data calculated by dividing antidepressant users by the total number of male and female residents in each age group.


RESULTS
During the 12 months surveyed 153,706 subjects were dispensed one or more prescriptions of antidepressants, yielding a prevalence of use of 9.49 subjects per 100 inhabitants (95% confidence interval 9.44, 9.53). Although the proportion of chronic users slightly decreased with age, more than 35% of those older that 85 years were moderate or chronic antidepressant users. General practitioners issued the majority of antidepressant prescriptions, and most antidepressant users were also dispensed agents for medical disorders.


CONCLUSIONS
The very high rates of antidepressant drug prescribing detected in late life suggest the need of characterising these subjects in terms of medical and psychiatric characteristics, needs and quality of life. It also suggests the need for pragmatic clinical trials, carried out in the general practice, with the aim of assessing whether antidepressants are effective in these conditions.
Percudani
Mauro
M
Health Care Directorate, Region of Lombardy, Milan, Italy. Mauro_Percudani@regione.lombardia.it
Barbui
Corrado
C
Fortino
Ida
I
Petrovich
Lorenzo
L
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D016001:Confidence Intervals; D016208:Databases, Factual; D006801:Humans; D007558:Italy / Q000453:epidemiology; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology*; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D011788:Quality of Life
D000928:Antidepressive Agents