Potentially inappropriate antidepressant use among older adults and comparison with young people in Turkey

The main question of this thesis study is "Is the use of potentially inappropriate antidepressant decreased in old age compared to young people?" The appropriateness of antidepressant drugs prescribed by family physicians to persons aged 15 years and over, according to the Beers Criteria, was examined in Turkey in 2019. The data were obtained by the TITCK (Turkey Pharmaceuticals and Medical Devices Agency) – RBS (Recipe Information System). The calculations were made on the ratio of prescriptions containing potentially inappropriate antidepressants to all prescriptions that were written in that year. In 2019, family physicians wrote 139.288.644 prescriptions for all individuals aged 15 and over, and 44.621.603 prescriptions for 65 years and above, Young people were prescribed less than the population distribution, while more prescriptions were prescribed to the geriatric people than the population distribution. The number of prescriptions containing amitriptyline, imipramine, clomipramine or paroxetine, which are considered as potentially inappropriate antidepressants in the elderly is 281.128 according to Beers criteria. This number is 0.63% of the total prescriptions written to the elderly in 2019. It is statistically lower than the rate (0.74%) in the young population. Among these four drugs, paroxetine was the most prescribed to the geriatric population. The rate of drugs that should be used carefully according to Beers Criteria is 3.95%. Among these drugs, the rate of prescribing citalopram, escitalopram, maprotiline, mirtazapine and sertraline are higher than the distribution of prescriptions in total. Among these drugs, the rate of prescribing duloxetine, fluoxetine, fluvoxamine, milnacipran and venlafaxine are lower than the distribution of prescriptions in total. As a result, potential inappropriate use of antidepressants in the elderly was studied and compared with the younger population in Turkey for the first time. This research points to the importance of geriatric pharmacology and the awareness of our family physicians on this issue.