Antidepressant use over time in a rural older adult population: The MoVIES project

OBJECTIVE: To examine the use of antidepressant drugs over time among community-based older persons. DESIGN: A longitudinal community study with four approximately biennial data collection waves (1987 - 1996). SETTING: A low-socioeconomic status rural older community-based population in Southwestern Pennsylvania. PARTICIPANTS: A total of 1681 individuals with a mean age of 72.9 years at study entry, MEASUREMENTS: Antidepressant drug use, demographics, and health services utilization by self-report. RESULTS: Antidepressant use was reported by less than 5% of the population during all four waves. It was associated with female gender, use of mental health services, presence of five or more depressive symptoms, and use of five or more prescription drugs, but not with age. During the foul: waves, tricyclics accounted for 84.6%, 85.3%, 78.4%, and 45.5% of total antidepressants used, whereas selective serotonin reuptake inhibitors (SSRIs) accounted for 2.6%, 11.8%, 8.1%, and 36.4%. CONCLUSIONS: Overall, our data on antidepressant use in this rural older population mirror national trends away from tricyclics and towards SSRIs. Our findings also suggest underutilization of mental health services and antidepressant drugs in this population.