Psychiatry AdvisorMost Adults Working Beyond Age 65 Years Do Not Require Antidepressant Therapy

ℹ️ Observational Association Only Evidence

A 10-year Swedish register-based cohort study tracked antidepressant prescriptions in 32,849 adults who exited paid work between ages 65 and 70. Nearly 90% received no antidepressants across the full observation window; prior mental health–related sickness absence or disability pension was the strongest predictor of prescription use.

Clinical Considerations

• 89.6% of the cohort did not receive any antidepressants during the 10-year period; prescription prevalence decreased slightly after work exit
• Among those prescribed antidepressants, 94.1% followed a stable “Constant” trajectory; only 0.6% of the total cohort showed an “Increasing” pattern
• Prior mental health absence tripled the likelihood of belonging to the Constant trajectory (OR 3.33) and nearly tripled Increasing trajectory membership (OR 2.97)
• Foreign-born participants were twice as likely to follow an Increasing trajectory, suggesting demographic factors warrant attention in retirement-age care planning

Practice Applications

• Recognize that work exit itself does not appear to drive antidepressant initiation in most older adults
• Monitor patients with prior mental health–related disability or sickness absence as a higher-risk subgroup at retirement transition
• Interpret antidepressant prescription data in this population cautiously; adherence and indication were not confirmed in this register-based design
• Consider country of origin as a contextual factor when assessing psychiatric risk in older adults transitioning out of the workforce