This study will examine therapeutic and adverse effects of continuing versus discontinuing
antidepressant medication in nursing home residents who have had no more than a single
episode of depression and who no longer have depressive symptoms.
There are approximately 1.6 million nursing home residents in the United States. More than
one third of these residents are taking antidepressant medications (ADs). Although ADs are
effective, evidence suggests that they can lead to significant adverse events, including an
increased risk of falls and bone fractures. Many depressed nursing home residents suffer from
an initial episode of late-life depression and do not meet guideline-based recommendations
for maintenance treatment. This study will examine the benefits and risks of long-term AD
treatment in depressed nursing home residents whose single episode of depression has been in
continuous remission for at least six months.
Participants will be randomly assigned to either continue or discontinue AD treatment.
Participants will be monitored over a period of one year for recurrence of depression and
related symptoms, as well as for the occurrence of falls, fractures, and other adverse
events. Medical chart review, self-reported mood symptoms, and depression scales will be used
to assess participants.
- Current use of antidepressant medication
- Have been in remission from first episode of depression for 6 months or longer
- Currently residing in a long term care or assisted living facility
- Severe cognitive impairment