UMN study shows that antidepressants are overprescribed among older adults

University students researched the trend of inappropriately prescribed antidepressants.

by Lauren Otto

A recent University of Minnesota study shows doctors often overprescribe antidepressants in older populations.

The study found 2.2 million annual antidepressant-related outpatient visits exposed those older than 65 to the risk of possibly avoidable adverse drug events. In an adverse event, blood pressure can drop and lead to fainting and falling in older adults.

Using national databases from 2002 to 2012, the study showed that overall antidepressant prescriptions nearly doubled, with more than 260 million prescriptions annually.

Greg Rhee, lead author of the study and a graduate student in the University’s College of Pharmacy, said older adults often receive prescriptions for multiple medications, and sometimes these cause more harm than benefit.

He said, in some cases, doctors inappropriately prescribe antidepressants for conditions like insomnia and migraines.

Jon Schommer, coauthor and director of graduate studies in social and administrative pharmacy for the University, said the study adds to the literature and evidence of antidepressant over-prescription, which requires more action to address.

“There’s still areas of improvement for medication use for the treatment of depression in older individuals,” he said. “These are public health issues.”

Rhee, who has worked as a social worker with older adults, said the overall study findings spotlight the vulnerability of older adults and many cases of potentially avoidable hospitalization.

The research also showed racial and ethnic minorities have a higher chance of potentially inappropriate prescription.

Hispanics and non-Hispanic blacks were 3.93 times more likely than others to be prescribed antidepressants.

“It is a health care disparity problem that not everybody has equal access to care, or even if they do have access to care, the quality of care that they receive is different by racial and ethnic groups,” Rhee said

Because the research showed that antidepressant prescriptions and potentially inappropriate ones are increasing, Rhee sees an opportunity to keep working on this issue.

He said he wants to start research on why it happens and how to address it.

Steven Hollon, a psychology and psychiatry professor at Vanderbilt University, said medical practices in the U.S. rely too heavily on medications despite other better options for treatment, which leads to the over-prescription problem.

“Most folks that are on medication don’t need to be,” Hollon said.

Improving collaboration in medicinal management among doctors, pharmacists and other health care professionals will be crucial to reducing inappropriate prescriptions, Rhee said.

“We all need to be responsible for taking good care of the older adult population, specifically looking into the medication utilization and medication experiences by older adults,” he said.