On 2015 Jan 05, Peter Gøtzsche commented:

Antidepressant drugs should not be used in old people

Warren D. Taylor mentioned that people with late-onset depression are at higher risk for subsequent dementia.1 However, none of the references he provided lend support to the idea that it is the disease that causes the dementia. It is more likely that it is the antidepressant drugs that cause the dementia, e.g. benzodiazepines double the risk for dementia.2

Taylor also noted that depressed older adults are at increased risk for suicide and he recommends SSRIs. However, it has never been shown in reliable studies that SSRIs protect against suicide, but it has been shown that they cause suicide.3 Further, as Taylor noted, SSRI cause falls, which is detrimental in old people, as 20-25% die when they get a hip fracture. A meticulous cohort study of depressed people over 65 years of age, in which the patients were their own controls, showed that for every 28 people treated for 1 year with an SSRI, there was one additional death, compared to no treatment. A further reason why antidepressants should not be used in old people is that their effect on the depression is doubtful.4

1. Taylor WD. Depression in the elderly N Engl J Med 2014;371:1228-36.

2. Billioti de Gage S, Moride Y, Ducruet T, et al. Benzodiazepine use and risk of Alzheimer's disease: case-control study. BMJ 2014;349:g5205.

3. Gunnell D, Saperia J, Ashby D. Selective serotonin reuptake inhibitors (SSRIs) and suicide in adults: meta-analysis of drug company data from placebo controlled, randomised controlled trials submitted to the MHRA’s safety review. BMJ 2005;330:385.

4. Gøtzsche PC. Why I think antidepressants cause more harm than good. Lancet Psychiatry 2014;1:104-6.

On 2014 Nov 19, Peter Gøtzsche commented:

Antidepressant drugs should not be used in old people

Warren D. Taylor mentioned that people with late-onset depression are at higher risk for subsequent dementia.1 However, none of the references he provided lend support to the idea that it is the disease that causes the dementia. It is more likely that it is the antidepressant drugs that cause the dementia, e.g. benzodiazepines can cause dementia.2

Taylor also noted that depressed older adults are at increased risk for suicide and he recommends SSRIs. However, it has never been shown in reliable studies that SSRIs protect against suicide, in fact they cause suicide.3 Further, as Taylor noted, SSRI cause falls, which is detrimental in old people, as many die when they get a hip fracture. A meticulous cohort study of depressed people over 65 years of age, in which the patients were their own controls, showed that for every 28 people treated for 1 year with an SSRI, there was one additional death, compared to no treatment. Antidepressants should not be used in old people, also because their effect on the depression is doubtful.4

1. Taylor WD. Depression in the elderly N Engl J Med 2014;371:1228-36.

2. Billioti de Gage S, Moride Y, Ducruet T, et al. Benzodiazepine use and risk of Alzheimer's disease: case-control study. BMJ 2014;349:g5205.

3. Gunnell D, Saperia J, Ashby D. Selective serotonin reuptake inhibitors (SSRIs) and suicide in adults: meta-analysis of drug company data from placebo controlled, randomised controlled trials submitted to the MHRA’s safety review. BMJ 2005;330:385.

4. Gøtzsche PC. Why I think antidepressants cause more harm than good. Lancet Psychiatry 2014;1:104-6

On 2014 Nov 19, Peter Gøtzsche commented:

Antidepressant drugs should not be used in old people

Warren D. Taylor mentioned that people with late-onset depression are at higher risk for subsequent dementia.1 However, none of the references he provided lend support to the idea that it is the disease that causes the dementia. It is more likely that it is the antidepressant drugs that cause the dementia, e.g. benzodiazepines can cause dementia.2

Taylor also noted that depressed older adults are at increased risk for suicide and he recommends SSRIs. However, it has never been shown in reliable studies that SSRIs protect against suicide, in fact they cause suicide.3 Further, as Taylor noted, SSRI cause falls, which is detrimental in old people, as many die when they get a hip fracture. A meticulous cohort study of depressed people over 65 years of age, in which the patients were their own controls, showed that for every 28 people treated for 1 year with an SSRI, there was one additional death, compared to no treatment. Antidepressants should not be used in old people, also because their effect on the depression is doubtful.4

1. Taylor WD. Depression in the elderly N Engl J Med 2014;371:1228-36.

2. Billioti de Gage S, Moride Y, Ducruet T, et al. Benzodiazepine use and risk of Alzheimer's disease: case-control study. BMJ 2014;349:g5205.

3. Gunnell D, Saperia J, Ashby D. Selective serotonin reuptake inhibitors (SSRIs) and suicide in adults: meta-analysis of drug company data from placebo controlled, randomised controlled trials submitted to the MHRA’s safety review. BMJ 2005;330:385.

4. Gøtzsche PC. Why I think antidepressants cause more harm than good. Lancet Psychiatry 2014;1:104-6

On 2015 Jan 05, Peter Gøtzsche commented:

Antidepressant drugs should not be used in old people

Warren D. Taylor mentioned that people with late-onset depression are at higher risk for subsequent dementia.1 However, none of the references he provided lend support to the idea that it is the disease that causes the dementia. It is more likely that it is the antidepressant drugs that cause the dementia, e.g. benzodiazepines double the risk for dementia.2

Taylor also noted that depressed older adults are at increased risk for suicide and he recommends SSRIs. However, it has never been shown in reliable studies that SSRIs protect against suicide, but it has been shown that they cause suicide.3 Further, as Taylor noted, SSRI cause falls, which is detrimental in old people, as 20-25% die when they get a hip fracture. A meticulous cohort study of depressed people over 65 years of age, in which the patients were their own controls, showed that for every 28 people treated for 1 year with an SSRI, there was one additional death, compared to no treatment. A further reason why antidepressants should not be used in old people is that their effect on the depression is doubtful.4

1. Taylor WD. Depression in the elderly N Engl J Med 2014;371:1228-36.

2. Billioti de Gage S, Moride Y, Ducruet T, et al. Benzodiazepine use and risk of Alzheimer's disease: case-control study. BMJ 2014;349:g5205.

3. Gunnell D, Saperia J, Ashby D. Selective serotonin reuptake inhibitors (SSRIs) and suicide in adults: meta-analysis of drug company data from placebo controlled, randomised controlled trials submitted to the MHRA’s safety review. BMJ 2005;330:385.

4. Gøtzsche PC. Why I think antidepressants cause more harm than good. Lancet Psychiatry 2014;1:104-6.