Older Patients' Aversion to Antidepressants. A Qualitative Study
Open accessAbstract
Background Depression is common among older patients yet is often inadequately treated. Patient beliefs about antidepressants are known to affect treatment initiation and adherence, but are often not expressed in clinical settings. Objective To explore attitudes toward antidepressants in a sample of depressed, community-dwelling elders who were offered treatment. DESIGN. Cross-sectional, qualitative study utilizing semi-structured interviews. Participants Primary care patients age 60 years and over with depression, from academic and community primary care practices of the University of Pennsylvania Health System and the Philadelphia Department of Veterans Affairs. Patients participated in either the Prevention of Suicide in Primary Care Elderly: Collaborative Trial or the Primary Care Research in Substance Abuse and Mental Health for the Elderly Trial. Sixty-eight patients were interviewed and responses from 42 participants with negative attitudes toward medication for depression were analyzed. Measurements Interviews were audiotaped, transcribed, and entered into a qualitative software program for coding and analysis. A multidisciplinary team of investigators coded the transcripts and identified key features of narratives expressing aversion to antidepressants. Results Four themes characterized resistance to antidepressants: (1) fear of dependence; (2) resistance to viewing depressive symptoms as a medical illness; (3) concern that antidepressants will prevent natural sadnes…
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The most frequent indications for psychotropic prescribing were depression in nine studies, sleeping disorders in seven and anxiety in six.
“The most frequent indications for psychotropic prescribing were depression in nine studies [50, 51, 55, 56, 60, 62, 73, 74, 82], sleeping disorders in seven [54–56, 59, 63, 74, 82] and anxiety in six [54–56, 73, 74, 82].”
From Stakeholders' views on the use of psychotropic medication in older people: a systematic review (2022) · cites this paper as [60]
Some older people felt medication did not address the root of their problem and was only a 'partial fix'.
“Some older people felt medication did not address the root of their problem and was only a ‘partial fix’ [50, 51, 56, 60, 74].”
From Stakeholders' views on the use of psychotropic medication in older people: a systematic review (2022) · cites this paper as [60]
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- Authors
- Givens, J. L., Datto, C. J., Ruckdeschel, K., Knott, K., Zubritsky, C., Oslin, D. W., Nyshadham, S., Vanguri, P., & Barg, F. K.
- Affiliations
- University of Pennsylvania (US)
- Philadelphia VA Medical Center (US)
- Venue
- Journal of General Internal Medicine
- Published
- 2006-02
- Volume
- 21
- Issue
- 2
- Pages
- 146-151
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC1484662
- OpenAlex
- W2765219543
- Cited by
- 116
- References
- 42
- Citations by year
- 2025: 4 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 5 · 2020: 6 · 2019: 2 · 2018: 7 · 2017: 1 · 2016: 3 · 2015: 6 · 2014: 5 · 2013: 9 · 2012: 7
- FWCI
- 8.03
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (P30MH052129, P30MH066270, 5P30 MH 52129)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Keywords
- antidepressants, geriatric depression, patient attitudes, fear of dependence, conceptualization of depression, patient-provider communication, primary care, community-dwelling older adults
- MeSH terms
- Aged, Aged, 80 and over, Aging, Antidepressive Agents, Attitude to Health, Cross-Sectional Studies, Depression, Fear, Female, Humans, Interviews as Topic, Male, Medical Records, Middle Aged, Patient Acceptance of Health Care, Patients, Substance-Related Disorders
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