title: Can selective serotonin inhibitor drugs in elderly patients in nursing homes be reduced?
abstract: OBJECTIVE
  To investigate whether treatment with selective serotonin reuptake inhibitors (SSRIs) could be withdrawn for elderly residents who had been on treatment for at least one year and to evaluate a method for systematic drug review.
  
  
  METHODS
  Open, prospective, interventional study.
  
  
  METHODS
  Four counties in Sweden.
  
  
  METHODS
  Elderly residents at 19 nursing homes, with ongoing treatment with SSRIs for more than one year.
  
  
  METHODS
  Clinical evaluation, registration of drugs used and rating with Montgomery-Asberg Depression Rating Scale (MADRS). A semi-structured telephone interview with 15 participating physicians and 19 nurses.
  
  
  RESULTS
  About one-third of all 822 residents in the nursing homes had ongoing antidepressant treatment, predominantly with SSRIs; 75% of them had been treated with SSRIs for at least one year and 119 (60%) of these were considered eligible for the study. The intervention was judged successful in 52% of these residents of whom 88% had a MADRS rating of less than 20 points. The GPs and the nurses experienced the method as practicable.
  
  
  CONCLUSIONS
  Withdrawal of SSRI treatment was successful in the majority of cases. The MADRS may be a valuable addition to clinical evaluation when deciding whether to end or continue SSRI treatment.
authors.affiliation: Unit of Research and Development in Primary Care, Jönköping, Sweden. kjell.lindstrom@lj.se
authors.forename: Kjell
authors.initials: K
authors.lastname: Lindström
authors.forename: Anders
authors.initials: A
authors.lastname: Ekedahl
authors.forename: Anders
authors.initials: A
authors.lastname: Carlsten
authors.forename: Jan
authors.initials: J
authors.lastname: Mårtensson
authors.forename: Sigvard
authors.initials: S
authors.lastname: Mölstad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy; D017723:Drug Utilization Review / Q000379:methods*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D019338:Polypharmacy; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors