<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_gp-2018-0005_s_006_w2aab3b7b4b1b6b1aab1c16b1Aa"><h3>Objectives</h3><p>There is almost no data on antidepressant prescribing in older adults treated with polypharmacy, although this population represents approximately 50% of older patients. These patients are frequently excluded from double-blind randomized controlled trials, meta-analyses and existing treatment guidelines. The main aim of this paper was to identify data on antidepressant prescribing in depressed older adults on polypharmacy using a systematic review.</p></sec><sec id="j_gp-2018-0005_s_007_w2aab3b7b4b1b6b1aab1c16b2Aa"><h3>Methods</h3><p>Randomized controlled clinical trials (RCTs) and other clinical trials in Medline/PubMed without language limitation (-2017) were searched to identify those with older depressed patients on polypharmacy. Only elderly patients (>65 years as mean) were included. Only approved antidepressants were included.</p></sec><sec id="j_gp-2018-0005_s_008_w2aab3b7b4b1b6b1aab1c16b3Aa"><h3>Results</h3><p>The systematic search identified 26 different clinical trials, although only one clinical open label trial with sertraline met the final inclusion criteria. This sertraline trial indicated the absence of clinically important drug-drug interactions and confirmed the effectiveness and safety of sertraline in routine clinical practice. Heterogeneity in this trial was high in almost all the categories except attrition and reporting bias.</p></sec><sec id="j_gp-2018-0005_s_009_w2aab3b7b4b1b6b1aab1c16b4Aa"><h3>Conclusions</h3><p>Sertraline has the highest evidence level in older adults with depression on polypharmacy. According to the results of this review and due to a low number of appropriate trials, a basic understanding of psychopharmacology is the possible approach to avoid serious problematic drug combinations in these patients. Newer RCTs are also urgently needed. This is the first systematic review including patients treated with polypharmacy, and therefore, its results are important in the field of evidence-based medicine.</p></sec></abstract>

ObjectivesThere is almost no data on antidepressant prescribing in older adults treated with polypharmacy, although this population represents approximately 50% of older patients. These patients are frequently excluded from double-blind randomized controlled trials, meta-analyses and existing treatment guidelines. The main aim of this paper was to identify data on antidepressant prescribing in depressed older adults on polypharmacy using a systematic review.MethodsRandomized controlled clinical trials (RCTs) and other clinical trials in Medline/PubMed without language limitation (-2017) were searched to identify those with older depressed patients on polypharmacy. Only elderly patients (>65 years as mean) were included. Only approved antidepressants were included.ResultsThe systematic search identified 26 different clinical trials, although only one clinical open label trial with sertraline met the final inclusion criteria. This sertraline trial indicated the absence of clinically important drug-drug interactions and confirmed the effectiveness and safety of sertraline in routine clinical practice. Heterogeneity in this trial was high in almost all the categories except attrition and reporting bias.ConclusionsSertraline has the highest evidence level in older adults with depression on polypharmacy. According to the results of this review and due to a low number of appropriate trials, a basic understanding of psychopharmacology is the possible approach to avoid serious problematic drug combinations in these patients. Newer RCTs are also urgently needed. This is the first systematic review including patients treated with polypharmacy, and therefore, its results are important in the field of evidence-based medicine.

Antidepressant drugs for older patients on polypharmacy: a systematic review reveals best evidence for sertraline

Global Psychiatry

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

ObjectivesThere is almost no data on antidepressant prescribing in older adults treated with polypharmacy, although this population represents approximately...

Antidepressant drugs for older patients on polypharmacy: a systematic review reveals best evidence for sertraline

Publié en ligne: 01 juin 2018

Pages: 17 - 24

Reçu: 29 déc. 2017

Accepté: 09 avr. 2018

DOI: https://doi.org/10.2478/gp-2018-0005

Mots clés
Antidepressants, older patients, medication prescribing, polypharmacy, systematic review, sertraline

© 2018 Stuhec Matej, Serra-Mestres Jordi, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Antidepressant drugs for older patients on polypharmacy: a systematic review reveals best evidence for sertraline

Publié en ligne: 01 juin 2018

Pages: 17 - 24

Reçu: 29 déc. 2017

Accepté: 09 avr. 2018

DOI: https://doi.org/10.2478/gp-2018-0005

Mots clésAntidepressants, older patients, medication prescribing, polypharmacy, systematic review, sertraline

© 2018 Stuhec Matej, Serra-Mestres Jordi, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Mots clés
Antidepressants, older patients, medication prescribing, polypharmacy, systematic review, sertraline