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Antidepressant-Treated Patients in Ambulatory Care

Mortality During a Nine-Year Period after First Treatment

Published online by Cambridge University Press:  02 January 2018

Kerstin Bingefors ,
Dag Isacson ,
Lars Von Knorring ,
Björn Smedby  and
Kristina Wicknertz
Kerstin Bingefors*
Affiliation:
Department of Pharmacy, Pharmaceutical Services Research, and Centre for Primary Care Research, Department of Social Medicine, and Department of Psychiatry, University Hospital, Uppsala University
Dag Isacson
Affiliation:
Department of Pharmacy, Pharmaceutical Services Research, and Centre for Primary Care Research, Uppsala University
Lars Von Knorring
Affiliation:
Department of Psychiatry, University Hospital, Uppsala University
Björn Smedby
Affiliation:
Centre for Primary Care Research, Department of Social Medicine, Uppsala University
Kristina Wicknertz
Affiliation:
Department of Pharmacy, Pharmaceutical Services Research, Uppsala University, Sweden
*
Kerstin Bingefors, Department of Pharmacy, Pharmaceutical Services Research, Uppsala University Biomedical Centre, PO Box 586, S-751 23 Uppsala, Sweden
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Abstract

Background

Non-institutionalised patients treated with antidepressants have been shown to have indicators of a generalised vulnerability, such as high rates of health service use and excessive prescription drug use. Therefore, mortality in this patient group is of interest.

Method

All first-incidence antidepressant users in a defined population during a five-year period were identified. Their total mortality during a nine-year follow-up was analysed. Cox proportional hazards regression was used to analyse total mortality, and mortality in cardiovascular disease, controlling for baseline chronic medical disease.

Results

Antidepressant treatment at the index date was a statistically significant predictor for increased long-term mortality in the over-65s, even when controlling for pre-existing chronic medical disease. Baseline ischaemic heart disease and concurrent antidepressant treatment significantly predicted mortality from cardiovascular causes.

Conclusion

Prescribed antidepressant treatment identifies patients who are at risk of increased mortality. For the physician in ambulatory care, knowledge of a patient's antidepressant treatment history may be a valuable tool in managing patient care.

Type
Papers
Information
The British Journal of Psychiatry , Volume 169 , Issue 5 , November 1996 , pp. 647 - 654
Copyright
Copyright © Royal College of Psychiatrists, 1996 

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