To summarize, within this thesis, we aimed to study characteristics and unintended effects of antidepressant use in clinical practice in an ageing population. Prevalence of antidepressant use, mainly Selective Serotonin Reuptake Inhibitors (SSRIs), increased over a 20-year period within the Rotterdam Study. In contrast, incidence of antidepressant use decreased over the years. These opposing patterns were possible explained by a longer duration of treatment. Our results suggest that antidepressants are next to the traditional indications prescribed for a wide range of – possible off-label – indications such as neuropathic pain, stress and sleeping disorders. Moreover, there is room for improvement in the initiation (23% early drop-outs) and maintenance phase of treatment.
Regarding the possible unintended effects: first, antidepressants were inconsistently associated with the prevalence and occurence of microbleeds. Second, SSRI use was in cross-sectional and longitudinal analyses associated with a good sleep quality. Third, we observed that use of SSRIs was associated with hyponatremia and was transient over time, however, neither use of tricyclic antidepressants, nor other antidepressants was associated with an increased risk of hyponatremia. Fourth, we observed no association between use of SSRIs and, change in, bone mineral density.

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B.H.Ch. Stricker (Bruno) , L.E. Visser (Loes)
Erasmus University Rotterdam
The work in this thesis is supported by a grant from the Netherlands Organisation for Health Research and Development (ZonMw; Priority Medicines Elderly 113101002). The Rotterdam Study is supported by the Erasmus MC and Erasmus University Rotterdam; the Netherlands Organisation for Scientific Research (NWO); the Netherlands Organisation for Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly (RIDE); the Netherlands Genomics Initiative (NGI); the Ministry of Education, Culture and Science; the Ministry of Health Welfare and Sport; the European Commission (DG XII); and the Municipality of Rotterdam.
Erasmus MC: University Medical Center Rotterdam

Aarts, N. (2015, December 16). Utilization and Unintended Effects of Antidepressants in an Ageing Population. Erasmus University Rotterdam. Retrieved from