Derby, England — An alarming number of older adults are remaining on antidepressant medications for years, raising concerns about potential memory issues and an increased risk of serious falls, healthcare experts say. Currently, more than 20% of individuals aged 65 and older are prescribed these medications, a figure that has more than doubled over the last two decades.
As people age, the likelihood of experiencing adverse complications from these drugs can significantly increase. Doctors point to the growing evidence suggesting that withdrawal symptoms can be particularly challenging for older patients. Some specialists argue that general practitioners are neglecting to reassess the ongoing need for these medications and are not providing alternative treatments, such as psychotherapy, to elderly patients.
Dr. Ellie Cannon, a general practitioner and columnist, voiced her concern last month about patients remaining on antidepressants long after their initial mental health issues have faded. This sentiment resonated with many, including individuals who have been on these medications for over a decade. Bill Jennings, a 75-year-old retiree from Derby, shared that he has been taking antidepressants since 1990 and has never been advised by his physician to discontinue their use.
Heather Hicks, a 76-year-old from East Sussex, noted that she has been on such medication since 1996, initially prescribed for marital issues. Despite attempting to wean off the drugs three times, she encountered withdrawal symptoms that prevented her from stopping. “I wish the GP had recommended counseling rather than prescribing a drug that is so difficult to stop,” Hicks expressed.
Experts emphasize the importance of identifying older patients who could safely discontinue their use of antidepressants. Robert Howard, a Professor of Old Age Psychiatry at University College London, stated that many patients have remained on these medications for extended periods, even if they might no longer require them.
Currently, over eight million individuals in the UK are prescribed antidepressants. While there are no formal NHS guidelines governing the duration for which these medications should be taken, patients are typically advised to use them for at least six months after their symptoms improve. Selective serotonin reuptake inhibitors (SSRIs), the most commonly prescribed antidepressants, are designed to elevate serotonin levels, a neurotransmitter associated with mood regulation. However, they can lead to various side effects, including nausea, dizziness, and sexual dysfunction.
These side effects can be particularly problematic for older patients, who may already be prone to dizziness, resulting in an increased risk of falls that can lead to severe fractures. If patients attempt to discontinue their medication, they may also face withdrawal symptoms, such as sleep disturbances and mood fluctuations.
While some experts believe general practitioners bear responsibility for the growing trend of seniors remaining on antidepressants, they also acknowledge that viable alternatives are often not available. Statistics reveal that fewer than 6% of patients referred for talking therapy are over the age of 65, despite this demographic constituting nearly one-fifth of the overall population.
Many older patients, according to a psychiatrist familiar with the situation, are prescribed antidepressants without ever receiving adequate mental health evaluations. The psychiatrist remarked, “Because GPs do not routinely follow up with these patients, they often remain on the medications indefinitely.”
In contrast, General practitioners like Professor Dame Clare Gerada defend their practices, highlighting that loneliness and social isolation are common issues among elderly individuals. “Treatment involving social engagement, such as group therapy, can be beneficial for these patients,” she noted. Unfortunately, lengthy NHS waiting lists for such services have complicated matters, with many young individuals seeking mental health support contributing to the backlog. As a result, antidepressants remain the primary option for many older adults, underscoring the need for a more nuanced approach to treatment.