Warning over elderly patients being left on antidepressants for decades – as experts say it puts them at risk of memory problems and life-threatening falls
Thousands of older patients are being left on antidepressants for decades that puts them at risk of memory problems and life-threatening falls, experts warn.
More than one in five over-65s are now taking antidepressants – more than double the number of 20 years ago.
Doctors warn that as patients age, complications from taking the pills become more likely. Research also suggests older patients could be at greater risk of withdrawal symptoms.
Despite this, some experts accuse GPs of allowing patients to remain on antidepressants indefinitely and failing to offer elderly people safer forms of depression treatment, such as talking therapy.
Last month, The Mail on Sunday’s GP columnist Dr Ellie Cannon wrote that she was concerned some patients were remaining on the drugs long after their mental health issues have subsided.
In response, this newspaper heard from dozens of patients who had been taking the tablets for more than decade.
One 75-year-old from Derby has been taking antidepressants since 1990. Despite regular trips to the GP, Bill Jennings says no one has ever suggested he come off them.
Heather Hicks, a 76-year-old from East Sussex, says she has been on the tablets since 1996 after they were prescribed to help with marital problems. She has tried to stop taking them three times but has been unable to due to withdrawal symptoms.
More than one in five over-65s are now taking antidepressants – more than double the number of 20 years ago. Pictured: File photo
‘I wish the GP had suggested counselling rather than prescribing a drug that is so difficult to stop,’ Ms Hicks says.
Experts say it is crucial GPs identify older patients who can safely come off antidepressants.
‘We know that there are patients who have been on antidepressants for a very long time, who perhaps no longer need them,’ says Robert Howard, Professor of Old Age Psychiatry at University College London.
More than eight million people in the UK take antidepressants. There are no NHS guidelines setting out the length of time patients should stay on them, though they are told to take them for at least six months after symptoms subside.
The most common antidepressants are known as selective serotonin reuptake inhibitors (SSRIs), which work by increasing a chemical in the brain, serotonin, linked to good mood. But they have a number of potential side-effects, including agitation, nausea, dizziness, loss of libido, and, in men, erectile dysfunction.
In most cases, these symptoms are mild and generally improve over time. However, experts warn that these symptoms can become more debilitating in old age.
Most concerningly, older patients on antidepressants who suffer dizziness are at risk of falls that can lead to life-threatening bone fractures.
Though if they do try to come off them there is also the risk of suffering withdrawal symptoms, including restlessness, trouble sleeping and mood swings.
Doctors warn that as patients age, complications from taking the pills become more likely. Research also suggests older patients could be at greater risk of withdrawal symptoms. Pictured: File photo
Some experts argue that GPs are to blame for the rising number of older people left on antidepressants – but admit that patients are not always being offered viable alternatives.
Studies show that less than 6 per cent of patients referred for talking therapy are over-65, despite making up nearly 20 per cent of the population.
‘Many of these older patients are never seen by a mental health specialist, they’re just bunged on antidepressants by their GP,’ says one psychiatrist. ‘And then, because the GPs don’t check up on them, these patients remain on the tablets indefinitely.’
However, the GPs disagree. ‘The elderly often get depressed because they’re lonely and socially isolated,’ says Professor Dame Clare Gerada, former president of the Royal College of General Practitioners. ‘Treatment which involves some social engagement, like group counselling or therapy, would be great for these patients.
‘But NHS waiting lists for these treatments are years long, largely because so many young people have mental health issues now.
‘So there’s not really any other option other than antidepressants. However, we need to get better at working out which patients can eventually come off them.’
