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Duration of new antidepressant use and factors associated with discontinuation among community-dwelling persons with Alzheimer's disease.

https://arctichealth.org/en/permalink/ahliterature300475
Source
Eur J Clin Pharmacol. 2019 Mar; 75(3):417-425
Publication Type
Journal Article
Date
Mar-2019
Author
Reetta Kettunen
Heidi Taipale
Anna-Maija Tolppanen
Antti Tanskanen
Jari Tiihonen
Sirpa Hartikainen
Marjaana Koponen
Author Affiliation
School of Pharmacy, University of Eastern Finland, PO Box 1627, 70211, Kuopio, Finland.
Source
Eur J Clin Pharmacol. 2019 Mar; 75(3):417-425
Date
Mar-2019
Language
English
Publication Type
Journal Article
Keywords
Age Factors
Aged
Aged, 80 and over
Alzheimer Disease - drug therapy
Antidepressive Agents - administration & dosage - therapeutic use
Antipsychotic Agents - administration & dosage - therapeutic use
Cohort Studies
Female
Finland
Humans
Independent living
Male
Proportional Hazards Models
Registries
Sex Factors
Time Factors
Abstract
To study how long antidepressants initiated after diagnoses of Alzheimer's disease (AD) were used and factors associated with discontinuation of use among persons with Alzheimer's disease (AD). In addition, differences in duration of use between the antidepressants groups were compared.
Register-based Medication use and Alzheimer's disease (MEDALZ) cohort included 70,718 community-dwelling people with AD who were diagnosed during the years 2005-2011. For this study, the new antidepressant users were included after 1-year washout period (N?=?16,501; 68.6% females, mean age 80.9). The duration of antidepressant use was modeled with the PRE2DUP method. Factors associated with treatment discontinuation were assessed with Cox proportional hazard models and included age, gender, comorbid conditions and concomitant medications.
Median duration of the new antidepressant use period was 309 days (IQR 93-830). For selective serotonin reuptake inhibitor (SSRI) use, the median duration was 331 days (IQR 101-829), for mirtazapine 202 days (IQR 52-635), and for serotonin and norepinephrine reuptake inhibitors (SNRIs) 134 days (IQR 37-522). After 1-year follow-up, 40.8% had discontinued antidepressant use, 54.6% after 2 years and 64.1% after 3 years. Factors associated with treatment discontinuation were age over 85, male gender, diabetes, and use of memantine, opioids, and antiepileptics whereas benzodiazepines and related drugs and antipsychotic use were inversely associated with discontinuation.
Antidepressants are used for long-term among people with AD. Need and indication for antidepressant use should be assessed regularly as evidence on their efficacy for behavioral and psychological symptoms of dementia is limited.
PubMed ID
30413841 View in PubMed
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Risk of head and traumatic brain injuries associated with antidepressant use among community-dwelling persons with Alzheimer's disease: a nationwide matched cohort study.

https://arctichealth.org/en/permalink/ahliterature291878
Source
Alzheimers Res Ther. 2017 Aug 01; 9(1):59
Publication Type
Journal Article
Date
Aug-01-2017
Author
Heidi Taipale
Marjaana Koponen
Antti Tanskanen
Piia Lavikainen
Reijo Sund
Jari Tiihonen
Sirpa Hartikainen
Anna-Maija Tolppanen
Author Affiliation
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, PO Box 1627, 70211, Kuopio, Finland. heidi.taipale@uef.fi.
Source
Alzheimers Res Ther. 2017 Aug 01; 9(1):59
Date
Aug-01-2017
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Alzheimer Disease - epidemiology
Antidepressive Agents - therapeutic use
Case-Control Studies
Cohort Studies
Craniocerebral Trauma - complications - diagnosis - epidemiology
Depression - drug therapy - epidemiology
Female
Finland
Humans
Independent living
Male
Middle Aged
Proportional Hazards Models
Psychiatric Status Rating Scales
Risk factors
Abstract
Antidepressant use has been associated with an increased risk of falling, but no studies have been conducted on whether antidepressant use is associated with an increased risk of head injuries which often result from falling among older persons. The objective of this study was to investigate the risk of head and brain injuries associated with antidepressant use among community-dwelling persons with Alzheimer's disease.
A matched cohort study was conducted by comparing new antidepressant users (n?=?10,910) with two matched nonusers (n?=?21,820) in the MEDALZ study cohort. The MEDALZ cohort includes all community-dwelling persons newly diagnosed with Alzheimer's disease between 2005 and 2011 in Finland. Incident antidepressant users were identified based on register-based dispensing data from the Prescription register with a 1-year washout period for antidepressant use. Nonusers were matched with users based on age, gender, and time since Alzheimer's disease diagnosis. The outcome events were defined as any head injuries and traumatic brain injuries based on diagnoses in Hospital Discharge and Causes of Death registers. Propensity score adjusted Cox proportional hazard models were utilized. Sensitivity analyses with case-crossover design were conducted. All registers are linkable with unique personal identification numbers assigned for each resident.
Antidepressant use was associated with an increased risk of head injuries (age-adjusted event rate per 100 person-years 2.98 (95% confidence interval (CI) 2.49-3.06) during use and 2.43 (95% CI 2.06-2.35) during nonuse, adjusted hazard ratio (HR) 1.35, 95% CI 1.20-1.52) and traumatic brain injuries (age-adjusted event rate per 100 person-years 1.33 (95% CI 1.13-1.53) during use and 1.10 (95% CI 1.00-1.20) during nonuse, adjusted HR 1.26, 95% CI 1.06-1.50). The risk was highest during the first 30 days of use (HR 1.71, 95% CI 1.10-2.66 for head injuries; HR 2.06, 95% CI 1.12-3.82 for traumatic brain injuries) and remained at an elevated level for head injuries for over 2 years of use. In case-crossover analyses, antidepressant use was consistently associated with a higher risk of head injuries.
Antidepressant use was associated with an increased risk of the most severe outcomes, head and brain injuries, in persons with Alzheimer's disease. Antidepressant use should be carefully considered and the association confirmed in future studies.
Notes
Cites: Int J Clin Pract. 2009 Jul;63(7):1085-94 PMID 19570125
Cites: Ann Pharmacother. 2012 Jul-Aug;46(7-8):917-28 PMID 22811347
Cites: J Trauma Acute Care Surg. 2015 Sep;79(3):449-54 PMID 26535433
Cites: J Alzheimers Dis. 2015 ;49(1):211-20 PMID 26444790
Cites: Eur J Clin Nutr. 2015 Feb;69(2):205-10 PMID 25226820
Cites: Int J Geriatr Psychiatry. 2017 Jan;32(1):94-101 PMID 26924266
Cites: Clin Epidemiol. 2016 Oct 11;8:363-371 PMID 27785101
Cites: NeuroRehabilitation. 2007;22(5):341-53 PMID 18162698
Cites: Hum Psychopharmacol. 2004 Mar;19(2):135-9 PMID 14994325
Cites: J Am Geriatr Soc. 2006 Oct;54(10):1590-5 PMID 17038079
Cites: CNS Neurosci Ther. 2011 Dec;17(6):620-8 PMID 22070192
Cites: Eur Neuropsychopharmacol. 2014 Nov;24(11):1729-37 PMID 25453487
Cites: Int Psychogeriatr. 2015 Apr;27(4):669-72 PMID 25412711
Cites: J Am Geriatr Soc. 2003 Sep;51(9):1213-8 PMID 12919232
Cites: Multivariate Behav Res. 2011 May;46(3):399-424 PMID 21818162
Cites: BMJ. 2011 Aug 02;343 :d4551 PMID 21810886
Cites: Clin Epidemiol. 2013 Aug 07;5:277-85 PMID 23950660
Cites: Psychosomatics. 2014 Nov-Dec;55(6):536-47 PMID 25262043
Cites: J Head Trauma Rehabil. 2015 Nov-Dec;30(6):E9-17 PMID 25629257
Cites: J Clin Psychopharmacol. 2012 Apr;32(2):218-24 PMID 22367651
Cites: Am J Alzheimers Dis Other Demen. 2011 Feb;26(1):10-28 PMID 21282274
Cites: J Gerontol A Biol Sci Med Sci. 2007 Oct;62(10):1172-81 PMID 17921433
Cites: BMC Med Inform Decis Mak. 2015 Mar 25;15:21 PMID 25890003
Cites: Arch Gerontol Geriatr. 2006 Mar-Apr;42(2):217-24 PMID 16125808
Cites: Age Ageing. 2011 Jan;40(1):49-54 PMID 21087990
Cites: Drugs Aging. 2010 Apr 1;27(4):337-49 PMID 20359263
Cites: Neurology. 1984 Jul;34(7):939-44 PMID 6610841
Cites: BMJ Open. 2013 Jan 07;3(1):null PMID 23299113
Cites: J Gerontol A Biol Sci Med Sci. 2011 Dec;66(12):1384-92 PMID 21934126
Cites: PLoS One. 2013;8(3):e59124 PMID 23527106
PubMed ID
28764750 View in PubMed
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