pensioner senior
© Joe Giddens /PA
Number of over-65s taking anti-depressants has doubled between the early 1990s and lates 2000s.
The number of over-65s taking anti-depressants has doubled in two decades, amid warnings the elderly are being given pills they don't need.

Charities have called the rise "alarming", and raised concerns that pills are frequently "doled out" when other "extremely effective" treatments are not being offered.

The increase is even more prominent among care home residents, with the number taking the medication four times higher over the period.

Comparing data from the early 1990s against the late 2000s researchers, from the University of East Anglia, found the percentage of over-65s on antidepressants increased from 4.2 to 10.7 percent.

But the study, published today (MON) in the British Journal of Psychiatry, also found the number of eldery people diagnosed with depression remained consistent, from 7.9 percent in between 1990 and 1993, to 6.8 percent between 2008 and 2011.

The researchers said despite "substantial increases" to the medications being prescribed, there appears to be no change in the prevalence of later life depression.

"What you might hope for is, given the increase in antidepressants, that the prevalence would go down but that's what we didn't observe," said Professor Antony Arthur, lead author of the study.

One in 15 people over-65 suffer from depression, yet how to treat the symptoms most effectively remains "poorly understood", Prof. Arthur said.

It follows a damning report last month which found one in six British adults, 7.3 million people, are taking anti-depressants, as well as 5.6 million on opioid pain medications.

The review by Public Health England (PHE) found that, in England, almost 12 million adults a year are being prescribed drugs on which they may become dependent.

In response to the PHE report, Matt Hancock, the Health Secretary, said he was "incredibly concerned" by the situation, and committed to ensuring the situation does not escalate to epidemic being seen in the US.

The increase in the number of pensioners being on antidepressants could be due to "improved recognition and treatment of depression, overprescribing, or use of antidepressants for other conditions," Prof. Arthur said.
Expert advice | Stopping antidepressants

Nearly one third of people who try to stop taking antidepressants experience withdrawal symptoms, according to a 2014 survey by the Royal College of Psychiatrists.

The survey of more than 800 people found that anxiety, dizziness, "head zaps", stomach upsets, flu-like symptoms and depression were among the most common effects of withdrawal. One quarter of those in the survey were unaware there can be problems linked to stopping antidepressants.

The College advises that anyone who wishes to stop taking antidepressant medication should:
  • Discuss the options with their doctor and be aware of possible withdrawal
  • Choose a good time
  • Seek support from friends and family and investigate whether you will need time off work
  • Reduce the dose very slowly
  • Be prepared to increase the dose again if needed
  • Keep a diary of your symptoms and drug doses
  • Keep an eye on your mood, look after yourself and keep active
  • Practice cognitive behavioural therapy (CBT) and relaxation techniques
  • Go back to your doctor if you are worried about how you feel
Caroline Abrahams, Charity Director at Age UK, said it's "concerning that in so many cases the clinical response is to dole out pills".

"In fact, we know that 'talking therapies' like counselling, are often extremely effective in treating problems like depression, especially among older people.

"Unfortunately we also know that older people are less likely to be offered a talking therapy than younger people and it's high time that changed."

But she said if more older people are being identified, or self-identifying as "in need of help" that's a "good thing".

Dr John Beer, chairman of Action on Elder Abuse, said: "The significant rise in antidepressant prescribing to care home residents is alarming."

Although the use of the medication has risen across society as a whole, its increase among care home residents "could be an indication that their emotional needs are not being properly met in their care setting", he added.

Dr Beer said due to a "scarcity of resources" a GP's "only option" is to prescribe anti-depressants to those who could benefit from other treatments.
Depression | In numbers

91 million - days lost to depression/anxiety and stress each year

£26 billion - cost to business through lost productivity, sickness absence and staff turnover

300,000 - people forced to leave jobs each year because of depression, anxiety or stress

64.7 million - prescriptions for antidepressants on NHS

£266 million - cost to the NHS for antidepressants

£7.5 billion - total cost of depression to NHS

£105 billion - total cost of poor mental health to English economy
"What we're seeing here is the result of inadequately resourced care homes sitting within a wider culture of over-prescription in a struggling healthcare system," Dr Beer said.

But the Royal College of GPs said the increase in anti-depressant use among over-65s could indicate "a greater awareness and acceptance of mental health conditions in society".

Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: "We also have a much better understanding of the effectiveness of anti-depressants than we did in the early 90s - and it's important to remember that current evidence shows these drugs work well when prescribed appropriately.

"GPs will only prescribe anti-depressants after a full and frank conversation with their patient, taking into account the physical, psychological and social factors potentially impacting on their health.

"But we will also explore alternative options to drug therapy, such as talking therapies - and we know that many older people, who perhaps are lonely, might benefit more from social prescribing schemes, for example joining a class or local community group, than traditional treatments."