Prevalence of use and appropriateness of antidepressants prescription in acutely hospitalized elderly patients

Depression is often under-recognized in older patients, even if antidepressants (AD) are commonly prescribed, with a prevalence of use that increase with ageing [1]. Nevertheless, even if a diagnosis of depression is established, inappropriate treatment can occur [2]. Beers criteria are the most widely screening tools used to detect inappropriate prescription of drugs in people aged 65 years or more [3]. Since 2010, attempts to adapt the Beers' criteria have been made in Europe [4,5]. Tricyclic drugs are the ADs to be always avoided in the elderly, owing to their anticholinergic side effects, such as cognitive impairment, delirium, urinary retention and falls [3]. Selective serotonin reuptake inhibitors (SSRIs) should be used with caution because they can cause or exacerbate hyponatraemia [3]. To our knowledge no studies have been conducted on recent data collected in hospitalized older patients in order to assess the appropriateness of prescription of ADs. With this background, the objectives of this study were to investigate the prevalence of AD use and prescription appropriateness, according to the above-cited criteria, in a large cohort of older patients hospitalized in Italian internal medicine and geriatric wards from 2010 to 2017.