Controlled withdrawal of selective serotonin reuptake inhibitor drugs in elderly patients in nursing homes with no indication of depression

Objective. The aim of the investigation was to study the effects of withdrawing selective serotonin reuptake inhibitor (SSRI) drugs in nursing home patients, who had no documented diagnosis or symptoms of depression. Setting. The setting of the study was in 11 nursing homes in the county of Stockholm, Sweden. Participants. Participants were patients without dementia or history of depression who had received treatment with SSRI drugs for more than 6 months and who had no indications of anxiety disorder or major depression Design. The included patients (n=70) were randomized to either the intervention group (withdrawal of SSRI) or the control group (no change in treatment), 35 patients to each group. Main outcome measures. The patients were subjected to assessment using the following instruments: Montgomery-Angstromsberg depression rating scale, global assessment for functioning, health index and a symptom assessment form. Assessment was made at the start of the study and at the 3-month and 6-month follow-ups. Results. We found no significant difference between the intervention and control groups in any outcome measure. Conclusion. Treatment with SSRI drugs in patients without clinical major depression or anxiety disorder is often unjustified and should be discontinued.