Acta Neuropsychiatrica 2016 All rights reserved DOI: 10.1017/neu.2016.4 © Scandinavian College of Neuropsychopharmacology 2016 ACTA NEUROPSYCHIATRICA Differences in prescribing psychotropic drugs for elderly with depression Yu-Chi Huang 1 , Liang-Jen Wang 2 , Mian-Yoon Chong 1 1 Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; and 2 Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan Keywords: antidepressants; geriatric depression; inpatient; pharmacoepidemiology; prescription pattern Mian-Yoon Chong, Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, 123 Ta-Pei Road, Niao-Sung, Kaohsiung 83342, Taiwan. Tel: +886-7-7317123 ext 8753; Fax: +886-7-7326817; E-mail: mchong@cgmh.org.tw Accepted for publication February 04, 2016 Huang Y-C, Wang L-J, Chong M-Y. Differences in prescribing psychotropic drugs for elderly with depression. Objective: The escalating tendency of elderly population aged 65 and over, which grown up to 9% since 2001 in Taiwan, remarks the important issue of mental health among ageing population. Depression in the elderly is frequently undetected or inadequately treated. This study aimed to investigate the pharmacotherapy of elderly patients with depression by comparing the patterns of prescribing psychotropic drugs (psychotropics) of psychiatrists and non-psychiatrists. Methods: A random sampling of 5% of inpatients from the National Health Insurance (NHI) database in Taiwan from 2001 to 2003 was selected. In all, 1058 (0.9%) inpatients aged 65 and older with a diagnosis of any depressive disorder were included. The psychotropic prescribing pattern and the dosages used were analysed and compared. Physician specialties were based on the record of NHI database. Non-psychiatrists were defined by physicians other than psychiatry. Results: A total of 88% of elderly depressed inpatients had two or more comorbid physical illnesses. The most commonly prescribed psychotropics were: antidepressants (71.4%), anxiolytics (62.6%) and hypnotics (51.4%). Psychiatrists had a higher rate of prescribing psychotropics, except anxiolytics, than non-psychiatrists. Although selective serotonin reuptake inhibitors were commonly prescribed, non-psychiatrists preferred the use of tricyclic antidepressants and moclobemide. Trazodone was the most preferred antidepressant, but was generally used in low dosages. Conclusion: Psychiatrists generally utilised higher dosages of newer antidepressants than non-psychiatrists. Differences in the prescribing pattern of psychotropics existed between physician specialties. Further investigations are warranted to determine how the selection and dosing of drugs influence the outcome of depression on the elderly. Significant outcomes ∙ Psychiatrists had a significantly higher rate of utilising second-generation antidepressants with higher dosages than non-psychiatrists. ∙ Selective serotonin re-uptake inhibitors were the drugs of choice for both psychiatrists and non- psychiatrists, with no significant difference in prescription dosage. ∙ Trazodone was the most frequently prescribed antidepressant, but was generally prescribed in low dosages. Limitations ∙ The reimbursement data was not the most recent and had small sample size. ∙ The diagnoses of depression were not validated by a structural interview. ∙ The information about physical comorbidity or depression severity was not analysed. ∙ The results might not reflect all the elderly at the present time. 1