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3 results

  • Utilization patterns of antidepressants between 1991 and 2011 in a population-based cohort of middle-aged and elderly

  • N. Aarts, R. Noordam, A. Hofman, H. Tiemeier, B.H. Stricker, L.E. Visser
  • Journal:
    European Psychiatry / Volume 29 / Issue 6 / August 2014
    Published online by Cambridge University Press:
    15 April 2020, pp. 365-370
  • Background

    In middle-aged and older patients in whom antidepressant use increased in last decades, patterns of use might be of concern The objective of this study was to investigate the patterns of prevalence, incidence and duration of antidepressant use in an ageing population.

    Methods

    All participants (aged > 45 years) from the population-based Rotterdam Study were followed from January 1st 1991 until death, loss to follow-up, or end of the study period (December 31st 2011). Antidepressant drug dispensing, based on pharmacy records, were subdivided into Tricyclic Antidepressants (TCAs), Selective Serotonin Reuptake Inhibitors (SSRIs) and other antidepressants. One-year prevalence, 5-year incidence and duration of antidepressant use were calculated.

    Results

    Yearly prevalence of antidepressant use increased from 3.9% in 1991 to 8.3% of the population in 2011. The increase in SSRI use was 5.8-fold, whereas use of other antidepressants doubled and TCA use remained stable over time. Incidence of all antidepressants decreased from 23.9 to 14.2 per 1000 person-years between 1992 and 2011. The duration of a first treatment episode increased over time.

    Conclusion

    Despite the prevalence of antidepressant use increased over time, incidence did not, which is most likely explained by a longer treatment duration and recurrent episodes.

  • Psychotropic medication use and cognition in institutionalized older adults with mild to moderate dementia

  • Laura H. P. Eggermont, Kerst de Vries, Erik J. A. Scherder
  • Journal:
    International Psychogeriatrics / Volume 21 / Issue 2 / April 2009
    Published online by Cambridge University Press:
    26 February 2009, pp. 286-294

  • Background: Most studies examining psychotropic medication use on cognition in older persons with dementia include measures of global cognitive function. The present study examined the relationship between different types of psychotropic medication and specific cognitive functions in older people with dementia.

    Methods: Two hundred and six institutionalized older adults with dementia (180 women, mean age 85 years) were administered neuropsychological tests. Psychotropic medication use was extracted from their medical status and categorized as: sedatives, antidepressants and antipsychotics.

    Results: Analysis of covariance revealed that psychotropic consumers, and particularly those who used antipsychotics, performed worse on neuropsychological tests of executive/attentional functioning than non-consumers. There were no differences between consumers of other classes of psychotropic drugs and non-consumers. The number of psychotropic drugs used was inversely related to executive/attentional functioning.

    Conclusions: These findings show that in institutionalized older adults with dementia, specific impairment of cognitive function, i.e. executive/attentional impairments, are associated with antipsychotic medication use. Future longitudinal studies are recommended.

  • 8 - The interrelationship of depression and diabetes

  • from Part 2 - Depression and specific health problems
    • By Dominique L. Musselman, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA, Angela Bowling, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA, Natalie Gilles, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA, Hannah Larsen, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA, Ephi Betan, Georgia School of Professional Psychology, Atlanta, GA, USA, Lawrence S. Phillips, Department of Medicine, Division of Endocrinology, Emory University School of Medicine, Atlanta, GA, USA
  • Edited by Andrew Steptoe, University College London
  • Book:
    Depression and Physical Illness
    Published online:
    17 September 2009
    Print publication:
    26 October 2006, pp 165-194

  • Summary

    The World Health Organization (WHO) highlights that approximately 150 million people worldwide have diabetes mellitus. This chapter reviews the pathophysiological alterations related to glucose intolerance in depressed patients and the beneficial effects of depression treatment upon glycaemic control. Antidepressant agents have been recognised to affect glucose concentration. Understanding the bidirectional relationship between depression and diabetes, including the sociocultural, biological and psychological pathways of influence, is ultimately critical to the treatment and prevention of diabetes. Education, functional impact of diabetes and financial stress may contribute the most to depression and anxiety in patients with diabetes early in their disease. Gender differences also exist, which may interact with socioeconomic factors. Psychological distress often can be reduced through the use of cognitive-behavioural therapy (CBT). Effective treatment of depression in patients with type 1 or type 2 diabetes may normalise neuroendocrine and immuno-inflammatory hyperactivation, facilitate adherence to diet and exercise, and improve glycaemic control.