Antidepressants in older adults

For older adults, 15% of people aged 55 and over experience depression or anxiety.¹ Antidepressant use is disproportionally higher and rising among older Australians, despite potential harms including increased risk of falls and fractures, sedation, QT prolongation, hyponatraemia and postural hypotension.² This trend poses clinical and economic challenges, demanding targeted interventions to ensure appropriate and effective use of antidepressants in this vulnerable group.

Person-centred management of antidepressants is at the centre of the Quality Use of Medicines Alliance program delivered by PSA.

Working with consumers and clinical experts, we have developed a range of evidence-informed education interventions and resources to support improved quality use of antidepressants.

Click on the links below for available education offerings and resources to optimise the use of antidepressants in older adults.

The Antidepressants in older adults quality improvement (QI) toolkit supports pharmacists to develop and implement a quality improvement activity at their place of work focusing on optimising the use of antidepressants in older Australian adults.

Resources are tailored for pharmacists working across various practice settings including community pharmacy, general practice, Aboriginal and Torres Strait Islander Community Controlled Health Organisations, aged care facilities, and hospitals.

Other clinical tools and resources:

Summary guide that steps through the treatment options for managing depression or anxiety in an older adult.

Support clinician-patient discussions and encourage shared decision-making and action-planning for the management of depression or anxiety.

Suggested wording to help start a conversation with patients about deprescribing antidepressants.

A summary of medicines information to help guide prescribers when selecting an antidepressant for an older person diagnosed with anxiety or depression.

Summary information to help guide health professionals through the key elements of antidepressant deprescribing, including different tapering options and how to distinguish withdrawal symptoms from relapse.

A shared decision-making tool to support consumers thinking about tapering or stopping their antidepressant.

This Australian Pharmacist article discusses the role of pharmacists in providing education and support for depression and antidepressant use in older adults.

References:

1. Australian Bureau of Statistics. National Study of Mental Health and Wellbeing (2020-2022) . 2023. Available from: https://www.abs.gov.au/methodologies/national-study-mental-health-and-wellbeing-methodology/2020-2022

2. Australian Institute of Health and Welfare. Australian Institute of Health and Welfare. 2024 . Mental health prescriptions – Mental health. Available from: https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions