title: New antidepressant use in older adults: a Canadian population-based study (1997-2013).
abstract: There has been much attention on appropriate prescribing in older adults in recent years. Recent guidelines favor the use of newer antidepressants over older agents based on their safety profile in this population. This study aimed to examine whether there has been a decline in older antidepressants and an increase in newer antidepressants used by older adults.
  
  
  
  A retrospective cross-sectional study using administrative databases examined the annual incidence of antidepressant use (per 1000) of community-dwelling adults ≥60 years old between 1997/1998 and 2012/2013 in Manitoba, Canada.
  
  
  
  The population of Manitoba ≥60 years increased by 25.6% from 188,296 to 236,569 from 1997/1998 to 2012/2013. New antidepressant use peaked to 45.9 per 1000 in 1999/2000, and then decreased steadily to 30.5 per 1000 in 2012/2013 (p < 0.0001). Incident amitriptyline use was high but declined from 15.5 to 7.4 per 1000 (p < 0.001). An increase in incident trazodone, mirtazapine, and venlafaxine use was observed (p < 0.001).
  
  
  
  There has been an overall decrease in the annual incidence of antidepressant users in older adults over the last 16 years, with a marked decline in new amitriptyline use and an increase in the incidence of newer agents.
authors.affiliation: a College of Pharmacy, Faculty of Health Sciences , University of Manitoba , Winnipeg , Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Leong
authors.affiliation: b Department of Psychiatry, College of Medicine, Faculty of Health Sciences , University of Manitoba , Winnipeg , Canada.
authors.forename: Murray W
authors.initials: MW
authors.lastname: Enns
authors.affiliation: b Department of Psychiatry, College of Medicine, Faculty of Health Sciences , University of Manitoba , Winnipeg , Canada.
authors.forename: Jitender
authors.initials: J
authors.lastname: Sareen
authors.affiliation: a College of Pharmacy, Faculty of Health Sciences , University of Manitoba , Winnipeg , Canada.
authors.forename: Silvia
authors.initials: S
authors.lastname: Alessi-Severini
authors.affiliation: b Department of Psychiatry, College of Medicine, Faculty of Health Sciences , University of Manitoba , Winnipeg , Canada.
authors.forename: James
authors.initials: J
authors.lastname: Bolton
authors.affiliation: c Department of Community Health Sciences, Manitoba Centre for Health Policy, College of Medicine, Faculty of Health Sciences , University of Manitoba , Winnipeg , Canada.
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Prior
authors.affiliation: c Department of Community Health Sciences, Manitoba Centre for Health Policy, College of Medicine, Faculty of Health Sciences , University of Manitoba , Winnipeg , Canada.
authors.forename: Dan
authors.initials: D
authors.lastname: Chateau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000639:Amitriptyline / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D008803:Mianserin / Q000031:analogs & derivatives / Q000627:therapeutic use; D008875:Middle Aged; D000078785:Mirtazapine; D012189:Retrospective Studies; D014196:Trazodone / Q000627:therapeutic use; D000069470:Venlafaxine Hydrochloride / Q000627:therapeutic use
chemical_list: D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D000639:Amitriptyline; D008803:Mianserin; D000069470:Venlafaxine Hydrochloride; D000078785:Mirtazapine; D014196:Trazodone
keywords: Antidepressants; cross-sectional study; drug utilization; older adults