Antidepressant drugs in the elderly: are the indications as long term as the treatment?

In a community study of 761 people aged 70 years and over 45 (5.9%) were found to be taking long term tricyclic antidepressants. Forty four were compared with matched controls. There was no evidence that tricyclic antidepressants were being used to compensate for poor physical health or function. Twenty subjects had a clear history of depression; three of these required additional treatment and five might have coped without continued drug treatment. Twelve of the remainder had started treatment with tricyclic antidepressants as hypnotics and 11 as a trial because of suspected depression. They had continued taking the drugs over a long period. Regular review of both the adequacy of and the necessity for continued treatment with tricyclic antidepressants in the elderly is recommended.