Possible errors in treatment of depression

A new study documenting the treatment of late-life depression by Canadian health professionals will be presented today at the American Psychosomatic Society Annual Meeting in Vancouver, Canada.

The study is the first to assess whether people diagnosed with late-life depression receive 'guideline concordant pharmacotherapy'--medication recommended in guidelines issued by the Canadian Psychiatric Association.

The research, conducted by Dr. Maida Sewitch at the McGill University Health Centre (MUHC) in Montreal and funded by the Canadian Institutes of Health Research (CIHR), followed the initial medication dispensed to over 5258 Quebec seniors, immediately following diagnosis of depression.

Almost all the seniors studied (84%) were given some form of medication, but incredibly only slightly more than half (55%) were given the recommended first-line antidepressants according to the Canadian Psychiatric Association. "The rest (45%) were given other drugs, some of which are known to be unhelpful for depression, especially in the elderly," explains Dr. Sewitch.

One medication--a group of psychotropic drugs known as benzodiazepines--was dispensed to nearly 2000 of the study's late-life depression patients. "There is evidence to suggest that this group of drugs may worsen depression or result in cognitive problems and falls in the elderly," says Dr. Sewitch.

The study also suggests that men--commonly diagnosed by psychiatrists in hospital settings--are more likely to receive guideline concordant medication than women--commonly diagnosed by general practitioners in out-patient settings. "These results highlight possible worrisome errors in the diagnosis and treatment of late-life depression," says Dr. Sewitch. "Further research is required in order to unravel the complexities."

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