Restricted accessResearch articleFirst published online 2016-8-8
Evolution of the Antidepressant Prescribing in Alzheimer’s Disease and Related Disorders Between 2010 and 2014: Results from the French National Database on Alzheimer’s Disease (BNA)
Background: Safety warnings from health authorities are currently intended
to limit the use of psychotropic agents in dementia-related conditions. Evidence
concerning the use of antidepressants in dementia is, however, scarce and
contradictory.
Objective: To evaluate antidepressant use among individuals with Alzheimer’s
disease (AD) and related disorders in the French population between 2010 and 2014.
Method: Antidepressant prescriptions in individuals with AD, mixed dementia
(MD), and vascular dementia (VaD) in the French National Alzheimer Database between 2010
and 2014 were analyzed (N = 199,544).
Results: Multivariate analysis showed an annual significant increase
(p < 0.001) in the prescription rate of antidepressants from 26%
(2010) to 31% (2014), and identified female gender, younger age, higher education, living
in long-term facilities, more severe cognitive decline, and presence of vascular signs
(VaD and MD) as associated factors for antidepressant prescribing.
Conclusion: The annual increase of antidepressant prescribing among
individuals with AD, MD, and VaD in French specialized settings may be partially related
to the lack of current valuable medications for dementia-related behavioral symptoms.
LeongC (2014)
Antidepressants for depression in patients with dementia: A review of the
literature. Consult Pharm29, 254–263.
2.
ArbusC, GardetteV, BuiE,
CantetC, AndrieuS, NourhashemiF, SchmittL, VellasB, GroupRF
(2010) Antidepressant use in Alzheimer’s disease patients:
Results of the REAL.FR cohort. Int Psychogeriatr22, 120–128.
3.
van
AschIF, NuyenJ,
VeerbeekMA, FrijtersDH, AchterbergWP, PotAM
(2013) The diagnosis of depression and use of
antidepressants in nursing home residents with and without dementia.
Int J Geriatr Psychiatry28, 312–318.
4.
Bonin-GuillaumeS,
MartinG, ZafackJ, GentileG, Allaria-LapierreV,
SciortinoV, ThirionX, MicallefJ
(2014) Antipsychotic use in the cohort PACA-Alz in patients
with Alzheimer’s disease and other dementia in 2010.
Therapie69, 213–222.
5.
RattingerGB, BurcuM,
DutcherSK, ChhabraPT, RosenbergPB, Simoni-WastilaL,
FraneyCS, WalkerLD, ZuckermanIH
(2013) Pharmacotherapeutic management of dementia across
settings of care. J Am Geriatr Soc61, 723–733.
6.
TaipaleH, KoponenM, TanskanenA, TolppanenAM, TiihonenJ, HartikainenS
(2014) High prevalence of psychotropic drug use among
persons with and without Alzheimer’s disease in Finnish nationwide
cohort. Eur Neuropsychopharmacol24, 1729–1737.
7.
MartinezC, JonesRW, RietbrockS
(2013) Trends in the prevalence of antipsychotic drug use
among patients with Alzheimer’s disease and other dementias including those treated with
antidementia drugs in the community in the UK: A cohort study.
BMJ Open3, pii:e002080.
8.
Rojas-FernandezC,
MikhailM, BrownSG
(2014) Psychotropic and cognitive-enhancing medication use
and its documentation in contemporary long-term care practice.
Ann Pharmacother48, 438–446.
9.
LustenbergerI,
SchupbachB, von
GuntenA, MosimannU
(2011) Psychotropic medication use in Swiss nursing
homes. Swiss Med Wkly141, w13254.
10.
RosenbergPB, MielkeMM, HanD,
LeoutsakosJS,
LyketsosCG, RabinsPV, ZandiPP, BreitnerJC, NortonMC, Welsh-BohmerKA,
ZuckermanIH, RattingerGB, GreenRC, CorcoranC, TschanzJT
(2012) The association of psychotropic medication use with
the cognitive, functional, and neuropsychiatric trajectory of Alzheimer’s
disease. Int J Geriatr Psychiatry27, 1248–1257.
11.
BrunnstromH, PassantU, EnglundE, GustafsonL
(2013) History of depression prior to Alzheimer’s disease
and vascular dementia verified post-mortem. Arch Gerontol
Geriatr56, 80–84.
12.
CherbuinN, KimS,
AnsteyKJ
(2015) Dementia risk estimates associated with measures of
depression: A systematic review and meta-analysis. BMJ
Open5, e008853.
13.
BanerjeeS, HellierJ, RomeoR,
DeweyM, KnappM,
BallardC, BaldwinR, BenthamP, FoxC,
HolmesC, KatonaC, LawtonC, LindesayJ, LivingstonG, McCraeN, Moniz-CookE, MurrayJ, NurockS, OrrellM, O’BrienJ, PoppeM,
ThomasA, WalwynR, WilsonK, BurnsA
(2013) Study of the use of antidepressants for depression in
dementia: The HTA-SADD trial–a multicentre, randomised, double-blind, placebo-controlled
trial of the clinical effectiveness and cost-effectiveness of sertraline and
mirtazapine. Health Technol Assess17, 1–166.
14.
HuangTY, WeiYJ,
MoyoP, HarrisI, LucasJA, Simoni-WastilaL
(2015) Treated behavioral symptoms and mortality in medicare
beneficiaries in nursing homes with Alzheimer’s disease and related
dementias. J Am Geriatr Soc63, 1757–1765.
FolsteinMF, FolsteinSE, McHughPR
(1975) “Mini-mental test”. A practical method for grading the
cognitive state of patients for the clinician. J Psychiatry
Res12, 189–198.
18.
Le
DuffF, DevelayAE, QuetelJ, LafayP,
SchuckS, PradierC, RobertP, French
National Alzheimer d (2012) The 2008-2012 French
Alzheimer plan: Description of the national Alzheimer information
system. J Alzheimers Dis29, 891–902.
19.
RheeY, CsernanskyJG, EmanuelLL, ChangCG, ShegaJW
(2011) Psychotropic medication burden and factors associated
with antipsychotic use: An analysis of a population-based sample of community-dwelling
older persons with dementia. J Am Geriatr Soc59, 2100–2107.
20.
TartagliaMC, HuB,
MehtaK, NeuhausJ, YaffeK,
MillerBL, BoxerA
(2014) Demographic and neuropsychiatric factors associated
with off-label medication use in frontotemporal dementia and Alzheimer’s
disease. Alzheimer Dis Assoc Disord28, 182–189.
21.
SundquistJ, HamanoT, LiX,
KawakamiN, ShiwakuK, SundquistK
(2014) Neighborhood linking social capital as a predictor of
psychiatric medication prescription in the elderly: A Swedish national cohort
study. J Psychiatr Res55, 44–51.
22.
Jacquin-PiquesA,
SaccoG, TavassoliN, RouaudO, BejotY,
GiroudM, RobertP, VellasB, Bonin-GuillaumeS
(2015) Psychotropic drug prescription in patients with
dementia: Nursing home residents versus patients living at home.
J Alzheimers Dis49, 671–680.
23.
MaustDT, LangaKM, BlowFC,
KalesHC (2016)
Psychotropic use and associated neuropsychiatric symptoms among patients
with dementia in the USA. Int J Geriatr Psychiatrydoi: 10.1002/gps.4452
24.
MarengoniA, BianchiG, NobiliA, TettamantiM, PasinaL, CorraoS, SalernoF, IorioA,
MarcucciM, MannucciPM, InvestigatorsS
(2012) Prevalence and characteristics of antidepressant drug
prescriptions in older Italian patients. Int
Psychogeriatr24, 606–613.
25.
FereshtehnejadSM,
JohnellK, EriksdotterM
(2014) Anti-dementia drugs and co-medication among patients
with Alzheimer’s disease: Investigating real-world drug use in clinical practice using
the Swedish Dementia Quality Registry (SveDem). Drugs
Aging31, 215–224.
26.
PrescrireR
(2012) Médicaments de la maladie d’Alzheimer: à
éviter. Rev Prescrir32, 105.
27.
DesaiVC, HeatonPC, KeltonCM
(2012) Impact of the Food and Drug Administration’s
antipsychotic black box warning on psychotropic drug prescribing in elderly patients
with dementia in outpatient and office-based settings.
Alzheimers Dement8, 453–457.
28.
GonfrierS, AndrieuS, RenaudD, VellasB, RobertPH
(2012) Course of neuropsychiatric symptoms during a 4-year
follow up in the REAL-FR cohort. J Nutr Health Aging16, 134–137.
