Depression drugs may lead to apathy in the elderly
Last Updated: 2007-03-19 14:27:28 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Among depressed older adults, use of an SSRI antidepressant like Prozac may lead to apathy, even though it relieves symptoms of depression, clinicians in Canada report.
These findings support research reported "over the past decade that the use of SSRIs may associate with the emergence of apathy," Dr. Nahathai Wongpakaran and co-investigators from the University of Toronto, Baycrest, point out in the Annals of General Psychiatry.
Apathy is a psychological term used to describe a state of indifference, where an individual is unresponsive or indifferent to aspects of emotional, social, or physical life.
In the Baycrest Centre for Geriatric Care's Day Hospital Database, the Canadian team identified 384 elderly depressed patients; 160 were treated with an SSRI antidepressant and 224 with a non-SSRI antidepressant.
They determined that 153 SSRI users were apathetic at admission and 128 remained apathetic at discharge, while 214 patients who received other antidepressants were apathetic at admission and 157 remained apathetic at discharge.
While SSRI use was not a predictor of apathy at admission, it was at discharge, according to the researchers.
The SSRI user group had significantly more patients with apathy than the non-SSRI user group. The odds of an individual developing apathy was nearly 2-fold higher with SSRI use.
It's worth noting, the authors say, that apathetic behavior was lower at discharge than at admission to the day hospital in both groups. Therefore, both SSRIs and non-SSRIs appeared to be somewhat effective in treating the apathy of depression.
"Patients and caregivers," Wongpakaran and colleagues conclude, "should be informed to be more aware of this potential adverse effect when using SSRIs. Careful monitoring for apathy, and consideration of switching antidepressant class in patients presenting with apathy, should be undertaken in all patients receiving an SSRI."
SOURCE: Annals of General Psychiatry, online February 21, 2007.
