Is antidepressant use risk for head injuries in persons with - - PowerPoint PPT Presentation

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Is antidepressant use risk for head injuries in persons with - - PowerPoint PPT Presentation

Mar 12, 2023 113 likes •261 views

Is antidepressant use risk for head injuries in persons with Alzheimers disease matched cohort study Sirpa Hartikainen Professor of Geriatric Pharmacotherapy University of Eastern Finland CONFLICT OF INTEREST DISCLOSURE I have the

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Is antidepressant use risk for head injuries in persons with Alzheimer’s disease – matched cohort study

Sirpa Hartikainen Professor of Geriatric Pharmacotherapy University of Eastern Finland

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CONFLICT OF INTEREST DISCLOSURE

I have the following potential conflicts of interest to report

  • Lecture fee from MSD
  • Lecture fee form Professio
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Introduction

  • All psychotropic drugs are associated with

an increased risk of falls and injurous falls among older persons

  • Older persons are at increased risk for

traumatic brain injury (TBI) (Fu et al. 2015)

12.10.2017 Sirpa Hartikainenä

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Objective

  • To investigate the risk of head and brain

injuries associated with antidepressant use among community-dwelling persons with Alzheimer’s disease

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MEDALZ cohort

  • All persons diagnosed with Alzheimer’s

disease (AD) in Finland 2005-2011, based

  • n Finnish health-care registers N=70,718

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12.10.2017 Esityksen nimi / Tekijä

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AD diagnosis

One year washout for antidepressant use

Outcome

Matching 1-2 nonusers for each antidepressant initiator at the initiation date, based on: age, gender, time since AD diagnosis Matching with a nonuser

Matching with a nonuser

Nonuser censored when/ if he/she initiates antidepressant use

Study design –matched cohort among AD persons

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Exposure and outcomes

  • Antidepressant use was classified by ATC-codes

– Any antidepressant (N06A), – SSRIs versus other antidepressants

  • Diagnosis according ICD-10

– Head injuries (S0*)

  • Traumatic brain injuries (TBIs, S06 Intracranial injury)

from Hospital Discharge and Causes of Death registers

  • Cox proportional hazard models adjusted by age,gender,

comorbidities and drug use

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Results

  • 10,910 new antidepressant users and 21,820

matched nonusers were included

– 69% women, mean age of antidepressant users and nonusers was 79.5 (due to matching) – Median follow-up 249 days (IQR 77-642) for users and 656 days (IQR 316-1155) for nonusers

  • 1,373 head injuries were recorded and 677

(49%) of them were TBIs

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Results

  • Age-adjusted head injury rate per 100 person-

years was

– 2.98 (95% CI 2.49-3.06) during antidepressant use – 2.43 (95% CI 2.06-2.35) during nonuse

  • Age-adjusted TBI rate per 100 person-years

was

– 1.33 (95% CI 1.13-1.53) during antidepressant use – 1.10 (95% CI 1.00-1.20) during nonuse

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Hazard ratio on antidepressant use and head and traumatic brain injuries

Duration of use and antidepressant classes HR for head injuries is HR for TBIs

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Conclusions

  • Among persons with Alzheimer’s disease

antidepressant use was associated with severe injurious falls, causing head or brain injuries

  • Antidepressants seem not to be ”safer

choice” for treating neuropsychological symptoms of dementia

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Published in Alzheimer’s Research & Therapy 2017 The team working with this article Heidi Taipale. Marjaana Koponen, Antti Tanskanen, Piia Lavikainen, Reijo Sund, Jari Tiihonen, Sirpa Hartikainen

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Thank you for your attention!

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