Discontinuation of Antidepressants in Older Adults: A Literature Review.

Content Provider	Europe PMC
Author	Romdhani, Ahmed Lehmann, Stephanie Schlatter, Joël
Copyright Year	2023
Abstract	Polypharmacy increases the risk of unbearable side effects, drug–drug interactions, and hospitalizations in geriatric patients. The iatrogenic risk of inadequate management of antidepressants is very important in this population. Therefore, primary care physicians and geriatricians have the responsibility of the optimization of antidepressants prescriptions. Our work is a literature review of the European and the international guidelines regarding the management of antidepressants. We reviewed the PubMed database and Google scholar for articles and reviews from 2015. We also screened relevant articles for more references and searched the web for available European guidelines relevant to our topic. We divided our findings into four main inquiries that are Indication, effectiveness, tolerability, and iatrogenic risks. Poor or absence of effectiveness should lead to a readjustment of the treatment plan. In case of unbearable side effects, antidepressants should be stopped, and alternative non-pharmacological therapies should be proposed. Doctors should look out for drug–drug interaction risks in this population and constantly adjust the prescription. Prescription of antidepressants is not always evidence based which leads to heavy iatrogenic consequences. We suggest a simple 4-questions-algorithm that aims to remind doctors of the basics of good practice and helps in the process of deprescribing an antidepressant in older adults.
Page Count	9
ISSN	11766336
Journal	Therapeutics and Clinical Risk Management
Volume Number	19
PubMed Central reference number	PMC10066696
PubMed reference number	37013196
e-ISSN	1178203X
DOI	10.2147/TCRM.S395449
Language	English
Publisher	Dove
Publisher Date	2023-03-28
Access Restriction	Open
Rights License	This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). © 2023 Romdhani et al.
Subject Keyword	older adults antidepressant management deprescribing antidepressant
Content Type	Text
Resource Type	Article
Subject	Safety Research Pharmacology, Toxicology and Pharmaceutics Pharmacology (medical) Chemical Health and Safety