Long-Term Care Residents with Dementia and Depression Should Be Prescribed Antidepressants with Extreme Caution

The older population is steadily growing worldwide. The aging process often involves a continuous decline in cognitive function, normally leading to minor changes to cognitive processes such as memory retrieval and the speed at which information is encoded. For normal progression of aging, this functional decrease is not critical enough to have any debilitating effect on average daily activities. In cases where the decline is more significant, dementia, delirium, and depression can develop. Antidepressants are often used for the treatment of depression and dementia, but there is limited evidence showing that this type of pharmacotherapy is effective. Moreover, the prescription of these drugs often results in about half the patients experiencing recurrence of the original symptoms. Notwithstanding these uncertain results, attending physicians still rely on antidepressants as a standard option and prescribe them to 43.2% of patients with dementia and depression.

A recent study explored the clinical effectiveness and safety of antidepressants used to treat patients with dementia and comorbid depression. The study found that there was little evidence suggesting that antidepressants were beneficial for patients with depression and dementia. Most publications regarding this topic indicate that antidepressants taken by these patients do not lead to greater remission rates of depression or any related improvement in cognitive functionality than to the placebo treatments given as controls.

The study suggests that antidepressants may not be an appropriate option for treating these elderly patients. Residents in nursing homes and assisted living facilities that have dementia and depression should be prescribed antidepressants with extreme caution.