Lakey Susan L, Gray Shelly L, Ciechanowski Paul, Schwartz Sheryl, Logerfo James
Department of Pharmacy, University of Washington, Box 357630, Seattle, WA 98195, USA.
Am J Geriatr Pharmacother. 2008 Mar;6(1):12-20. doi: 10.1016/j.amjopharm.2008.03.004.
It is estimated that major depressive disorder affects 0.9% of community-dwelling older adults in the United States. However, as many as 18% of older US adults reportedly suffer from depressive symptoms that do not necessarily fit the criteria for major depressive disorder (eg, dysthmia, minor depression).
The goals of this study were to describe patterns of antidepressant medication use in older adults with dysthymia or minor depression and to examine factors associated with the use of antidepressants at baseline.
This was a secondary analysis using cross-sectional data collected during a randomized controlled trial conducted from 2000 through 2003. It involved community senior service agencies and in-home visits in Seattle, Washington. Adults aged >or=60 years who had minor depression or dysthymia and were receiving services through community senior service agencies or living in senior public housing were included. Study participants were classified as users or nonusers of antidepressants. Prescription medication use in the past 2 weeks was assessed at baseline and 6 and 12 months. Medication name, dose, and directions were recorded from the medication label. Logistic regression was used to examine variables associated with baseline antidepressant use.
A total of 138 patients (mean age, 73.00 years) were included; the majority of study participants were female (779.00%). Overall, 42.33% were nonwhite (34.3% black, 4.4% Asian, 1.5% American Indian/Alaskan Native, 0.7% Hispanic, and 1.5% other). At baseline, 36.2% of study participants (n = 50) were using antidepressants. Selective serotonin reuptake inhibitors were the most common class of antidepressants, used by 62.00%, 70.22%, and 71.11% of antidepressant users at baseline, 6, and 12 months, respectively. However, nortriptyline was the most common antidepressant at baseline, taken by 20.00% of antidepressant users. Use of other prescription medications was associated with antidepressant use at baseline.
We found antidepressant use to be low in these relatively poor, community-dwelling, ethnically diverse older adults with dysthymia and minor depression in 2000 through 2003, with 36.22% of participants using antidepressants at baseline. Antidepressant users were more likely to be taking other prescription medications than nonusers.
据估计，在美国，重度抑郁症影响着0.9%的社区老年居民。然而，据报道，多达18%的美国老年人患有抑郁症状，但不一定符合重度抑郁症的标准（如心境恶劣障碍、轻度抑郁症）。
本研究的目的是描述患有心境恶劣障碍或轻度抑郁症的老年人使用抗抑郁药物的模式，并研究基线时与使用抗抑郁药物相关的因素。
这是一项二次分析，使用了2000年至2003年进行的一项随机对照试验中收集的横断面数据。研究涉及华盛顿州西雅图的社区老年服务机构和上门家访。纳入年龄≥60岁、患有轻度抑郁症或心境恶劣障碍且通过社区老年服务机构接受服务或居住在老年公共住房中的成年人。研究参与者被分类为抗抑郁药物使用者或非使用者。在基线、6个月和12个月时评估过去2周内的处方药使用情况。从药物标签上记录药物名称、剂量和用法说明。使用逻辑回归分析来研究与基线抗抑郁药物使用相关的变量。
共纳入138例患者（平均年龄73.00岁）；大多数研究参与者为女性（77.90%）。总体而言，42.33%为非白人（34.3%为黑人，4.4%为亚洲人，1.5%为美洲印第安人/阿拉斯加原住民，0.7%为西班牙裔，1.5%为其他）。在基线时，36.2%的研究参与者（n = 50）使用抗抑郁药物。选择性5-羟色胺再摄取抑制剂是最常用的抗抑郁药物类别，在基线、6个月和12个月时，分别有62.00%、70.22%和71.11%的抗抑郁药物使用者使用该类药物。然而，去甲替林是基线时最常用的抗抑郁药物，20.00%的抗抑郁药物使用者服用该药物。在基线时，使用其他处方药与使用抗抑郁药物相关。
我们发现，在2000年至2003年期间，这些相对贫困、居住在社区、种族多样且患有心境恶劣障碍和轻度抑郁症的老年人中，抗抑郁药物的使用率较低，36.22%的参与者在基线时使用抗抑郁药物。与非使用者相比，抗抑郁药物使用者更有可能正在服用其他处方药。
