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The following is a summary of “Effects of deprescribing antidepressants in nursing home residents with dementia—a cluster randomized controlled trial,” published in the June 2025 issue of BMC Primary Care by Hølmkjær et al. 

Antidepressants were frequently prescribed to older nursing home residents with dementia, a neurological disorder, despite limited clinical benefit and substantial risk of side effects.  

Researchers conducted a retrospective study to examine the impact of a multifaceted intervention targeting nursing home general practitioners (GP) and their collaboration with staff on reducing antidepressant use among older residents with dementia.  

They recruited GPs working as nursing home physicians in the Capital Region of Denmark between June 1 and October 1, 2021. Eligible participants were individuals with dementia (diagnosed or suspected), aged ≥ 72 years, receiving 1 or more antidepressants, and residing in a nursing home associated with the participating physician. The intervention involved 3 components: a training session held at the nursing home, a pre-visit reflection tool, and a dialog tool used during a structured home visit. The control group received enhanced care as usual. The primary outcome was the reduction in a total defined daily dose (DDD) of antidepressants from pre- to post-intervention in the intervention group compared to the control group and secondary outcomes included mortality, changes in other psychotropic medications, hospitalizations, and symptoms.  

The results showed that 21 clusters were enrolled, including 128 eligible individuals (62 in the intervention group and 66 in the control group), with 4 clusters later withdrawing. Most individuals were women, with a median age of 85 years. On average, participants were prescribed 9 different medications. Sertraline and mirtazapine were the most frequently used antidepressants. The odds ratio (OR) for an antidepressant reduction in the intervention group compared to the control group was 2.3 (95% CI = 0.84–6.2). Mortality rates remained comparable between the 2 groups.  

Investigators concluded that the intervention did not lead to a significant reduction in antidepressant use among older nursing home residents with dementia. 

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-025-02894-y