[Prescription patterns of older and newer antidepressants for geriatric depressive out-patients]

To study the prescription patterns of antidepressants for an elderly population.

140 out-patients suffering an index depressive episode were studied and followed for at least one year.

Demografics: 75% women. Mean age: 72.4%. Mayor depression: 71%. Late-onset: 41%. The most frequently used types the frist choice were SSRIs (48.6%) and Tricyclics (45%), the molecules initially most prescribed: Fluoxetine (26%), Mianserin (13%) and Paroxetin (10%). Initial choice of treatment achieves satisfactory remission in 32.9% of the cases. 57% of patients needed a frist malecule switch, 23% received only two molecules, 16% three, 5% four and 11% five molecules or more. After the first switch, the initial SSRI was substituted by another SSRI in 48% of the cases and by a Tricyclic in 30%. Initial Tricyclic chaged to a SSRI in 33% and another Tricyclic in 45%. The patterns of Tricyclics and SSRIs use were not essentially different and both were used globally in the same proportion, although the most prescribed molecules were Fluoxetine, Fluvoxamine and Paroxetine. Both groups achieved statistically similar number of remissions and suppressions by intolerance or ineficcacy but tricyclics were increasingly used from the frist switch onwards.