The American Jo~rn¢! of" Geriatric Pb~rm~co#ber~py $.L. L~k£~ ¢:t ~1. Antidepressant Use in Nonmajor Depression: Secondary Analysis of a Program to Encourage Active, Rewarding Lives for Seniors (PEARLS), a Randomized Controlled Trial in Older Adults from 2000 to 2003 Susan L. Lakey, PharmD~; Shelly L. Gray, PharmD, MS~; Paul Ciechanowski, MD, MPH2,3; Sheryl Schwartz, MPA3; and James LoGerfo, MD, MPH 3,4 ;Department of Pharmacy, University of Washington, Seattle, Washington; :Deioartment of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington; sOepartment of Health Services,University of Washington, Seattle, Washington; and 4Department of /vledicine, University of t?¢ashington,Seattle, Washington ABSTRACT Background: It is estimated that major depressive disorder affects 0.9% of community-dwelling older adults in the United States. However, as many as 18% of older US adults reportedly suffer from depressive symptoms that do not necessarily fit the criteria for major depressive disorder (eg, @sthmia, minor depression). Objectives: The goals of this stu@ were to describe patterns of antidepressant medication use in older adults with @sthymia or minor depression and to examine factors associated with the use of antidepressants at baseline. Methods: This was a secondary analysis using cross-sectional data collected during a randomized controlled trial conducted fi'om 2000 through 2003. It involved communiw senior service agencies and in-home visits in Seattle, Washington. Adults aged >_60 years who had minor depression or dysthymia and were receiving services through communib ~senior service agencies or living in senior public housing were included. Study participants were classi- fied as users or nonusers of antidepressants. Prescription medication use in the past 2 weeks was assessed at baseline and 6 and 12 months. Medication name, dose, and directions were recorded from the medication label. Logistic regression was used to examine variables associated with baseline antidepressant use. Results: A total of ] 38 patients (mean age, 73.0 years) were included; the majority of stu@ participants were female (79.0%). Overall, 42.3% were nonwhite (34.3% black, 4.4% Asian, 1.5% American Indian/Alaskan Native, 0.7% Hispanic, and ] .5% other). At baseline, 36.2% of study participants (n = 50) were using antidepressants. Selec- tive serotonin reuptake inhibitors were the most common class of antidepressants, used by 62.0%, 70.2%, and 71.1% of antidepressant users at baseline, 6, and 12 months, respectively. However, nortriptyline was the most common antidepressant at baseline, taken by 20.0% of antidepressant users. Use of other prescription medications was associ- ated with antidepressant use at baseline. Conclusions: We found antidepressant use to be low in these relatively poor, comnmnity-dwelling, ethnically diverse older adults with @sthymia and minor depression in 2000 through 2003, with 36.2% of participants using antidepressants at baseline. Antidepressant users were more likely to be taking other prescription medications than nonusers. ( A m J Gcriat~" Pharn~cothc~'. 2008;6:12-20) © 2008 Excerpta Medica Inc. Key words: dysthymic disorder, minor depression, antidepressant use. Accepted/o~ publication February 4, 2008, (4 2008 Excerpta/V\edica Inc~All rights reserved. doi:l 0.1016/j.amjop harm2OO&03.004 1543-5946/$32.00 Ml~rcb 2008 Volume 6 • Number 1 12