Discontinuation of Antidepressants and the Risk of Medication Resumption among Community-Dwelling Older Adults with Depression in the US

Abstract

Antidepressants are among the most prescribed drugs in the US, but the current treatment patterns and modalities among older adults are unclear. This study assessed the patterns of discontinuation of antidepressants and the risk of medication resumption among community-dwelling older adults with depression. Using Medicare Current Beneficiary Survey (MCBS) data from 2015–2019, we identified 1084 beneficiaries with depression who newly initiated serotonergic antidepressants. The risk of medication resumption was explored using survival analysis. The median duration of continuous medication was 90 days. However, about 30% of patients had a treatment duration of 30 days or shorter, 26% for 31–90 days, 15% for 91–180 days, and 30% for 181 days or more. After adjusting for all covariates, patients with less than 30 days of continuous medication were half as likely to resume the medications compared to those with 91–180 days (HR: 0.49 (95% CI: 0.37, 0.65)). Nearly one-third of older adults used an antidepressant medication for a short duration with a lower risk of medication resumption. A shorter treatment duration without resumption might suggest over-prescription of antidepressants among community-dwelling older adults.