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Controlled withdrawal of selective serotonin reuptake inhibitor drugs in elderly patients in nursing homes with no indication of depression

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Abstract

Objective

The aim of the investigation was to study the effects of withdrawing selective serotonin reuptake inhibitor (SSRI) drugs in nursing home patients, who had no documented diagnosis or symptoms of depression.

Setting

The setting of the study was in 11 nursing homes in the county of Stockholm, Sweden.

Participants

Participants were patients without dementia or history of depression who had received treatment with SSRI drugs for more than 6 months and who had no indications of anxiety disorder or major depression

Design

The included patients (n=70) were randomized to either the intervention group (withdrawal of SSRI) or the control group (no change in treatment), 35 patients to each group.

Main outcome measures

The patients were subjected to assessment using the following instruments: Montgomery-Åsberg depression rating scale, global assessment for functioning, health index and a symptom assessment form. Assessment was made at the start of the study and at the 3-month and 6-month follow-ups.

Results

We found no significant difference between the intervention and control groups in any outcome measure.

Conclusion

Treatment with SSRI drugs in patients without clinical major depression or anxiety disorder is often unjustified and should be discontinued.

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Acknowledgements

We are grateful to The Swedish Foundation for Health Care Sciences and Allergy Research and the Federation of County Councils, Stockholm County Council, R&D Department. We also thank Jan Golebiowski, M.D., for assessing the patients in the follow-up.

Author information

Authors and Affiliations

  1. Division of Clinical Pharmacology, Stockholm South General Hospital, 11883 , Stockholm, Sweden

    Johanna Ulfvarson

  2. Department of Nursing, Karolinska Institutet, Sweden

    Johanna Ulfvarson & Regina Wredling

  3. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden

    Johanna Adami & Marie Reilly

  4. Department of Psychiatry, St. Göran’s Hospital, Sweden

    Bengt Kjellman

  5. Karolinska Institutet at Stockholm South General Hospital, Division of Clinical Pharmacology, Sweden

    Christer von Bahr

Authors
  1. Johanna Ulfvarson
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  2. Johanna Adami
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  3. Regina Wredling
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  4. Bengt Kjellman
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  5. Marie Reilly
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  6. Christer von Bahr
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Corresponding author

Correspondence to Johanna Ulfvarson.

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Ulfvarson, J., Adami, J., Wredling, R. et al. Controlled withdrawal of selective serotonin reuptake inhibitor drugs in elderly patients in nursing homes with no indication of depression. Eur J Clin Pharmacol 59, 735–740 (2003). https://doi.org/10.1007/s00228-003-0687-y

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  • DOI: https://doi.org/10.1007/s00228-003-0687-y

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