A scoping review of over-the-counter products for depression, anxiety and insomnia in older people.
Study Goal
The researchers aimed to evaluate the evidence for over-the-counter products, including melatonin, for treating insomnia in older adults.
Results Summary
The study found that melatonin had more substantive evidence for treating insomnia compared to other products, with most products appearing safe for use, though studies rarely included individuals with multiple comorbidities or on concomitant medications.
Population
Older adults with insomnia.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
melatonin | no change | insomnia | older adults | - | had more substantive evidence | #1 |
omega-3 fatty acids | no change | depression | older adults | - | had more substantive evidence | #2 |
BACKGROUND: Depression, anxiety, and insomnia are prevalent in older people and are associated with increased risk of mortality, dependency, falls and reduced quality of life. Prior to or whilst seeking treatment, older people often manage these symptoms or conditions using products purchased over the counter (OTC), such as medication or herbal products. This review aims to map the evidence available for OTC medications, herbal medicines and dietary supplements for depression, anxiety and insomnia in older adults. METHODOLOGY: We carried out a scoping review, including searches of five databases to identify relevant randomised controlled trials (inception-Dec 2022). We took an inclusive approach to products to represent the wide range that may be available online. Trials were summarised according to condition and product. RESULTS: We included 47 trials and 10 ongoing trial protocols. Most targeted insomnia (n = 25), followed by depression (n = 20), and mixed conditions (n = 2). None evaluated products targeted at anxiety alone. Where reported, most products appeared to be safe for use, but studies rarely included people with multiple comorbidities or taking concomitant medication. Some types of melatonin for insomnia (n = 19) and omega-3 fatty acids for depression (n = 7) had more substantive evidence compared to the other products. CONCLUSION: There is a substantial gap in evidence for OTC products for anxiety in older people. This should be addressed in future trials. Research should also focus on products that are widely used, and these need to be tested in older populations that are similar to those who would use them in practice.