Can selective serotonin inhibitor drugs in elderly patients in nursing homes be reduced?
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To investigate whether treatment with selective serotonin reuptake inhibitors (SSRIs) could be withdrawn for elderly residents who had been on treatment for at least one year and to evaluate a method for systematic drug review.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.
Lindström
Kjell
K
Unit of Research and Development in Primary Care, Jönköping, Sweden. kjell.lindstrom@lj.se
Ekedahl
Anders
A
Carlsten
Anders
A
Mårtensson
Jan
J
Mölstad
Sigvard
S
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
D017367:Selective Serotonin Reuptake Inhibitors