Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.
J Alzheimers Dis. 2011;26(2):231-7. doi: 10.3233/JAD-2011-110200.
Persons with Alzheimer's disease (AD) may be particularly susceptible to the adverse drug reactions associated with anti-epileptic drugs (AEDs). The objective of this study was to investigate the national pattern of AED use among community-dwelling persons with and without AD in Finland. All persons (n = 28,093) with a diagnosis of AD in 2005 were identified by the Social Insurance Institution of Finland (SII). The SII also identified comparison persons without AD individually matched in terms of age (± one year), gender, and region. Records of all reimbursed drug purchases in 2005 were extracted from the Finnish National Prescription Register. Conditional logistic regression was used to calculate unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for reimbursed AED use. Persons with and without AD were aged 42 to 101 (mean 80.0) years, with men comprising 32.2% (n = 9,048) of persons. Epilepsy was diagnosed for 2.1% of persons with AD compared to 1.3% of persons without AD (OR 1.66; 95% CI, 1.45 to 1.89). AEDs were used by 5.0% (n = 1417) of persons with AD compared to 3.4% (n = 955) persons without AD (adjusted OR 1.33; 95% CI, 1.21 to 1.46). The annual prevalence of phenytoin, clonazepam, valproic acid, and oxcarbazepine use was higher among persons with AD. In contrast, pregabalin use was lower among persons with AD (adjusted OR 0.83; 95% CI, 0.70 to 0.99). Use of older AEDs is more prevalent among persons with AD, despite persons with AD being particularly vulnerable to adverse drug reactions associated with many older AEDs.
患有阿尔茨海默病（AD）的人可能特别容易受到与抗癫痫药物（AED）相关的不良反应的影响。本研究的目的是调查芬兰社区居住的 AD 患者和非 AD 患者的 AED 使用模式。通过芬兰社会保险机构（SII）确定了所有 2005 年被诊断为 AD 的患者（n=28093）。SII 还按照年龄（±1 岁）、性别和地区对每位非 AD 患者进行了个体匹配。从芬兰国家处方登记处提取了 2005 年所有报销药物购买记录。使用条件逻辑回归计算了未调整和调整后的比值比（OR）和 95%置信区间（CI），以评估报销 AED 的使用情况。AD 患者和非 AD 患者的年龄为 42 至 101 岁（平均 80.0 岁），其中男性占患者的 32.2%（n=9048）。AD 患者中癫痫的诊断率为 2.1%，而非 AD 患者为 1.3%（OR 1.66；95%CI，1.45 至 1.89）。AD 患者中使用 AED 的比例为 5.0%（n=1417），而非 AD 患者为 3.4%（n=955）（调整后的 OR 1.33；95%CI，1.21 至 1.46）。AD 患者中苯妥英、氯硝西泮、丙戊酸和奥卡西平的年患病率较高。相反，AD 患者中普瑞巴林的使用率较低（调整后的 OR 0.83；95%CI，0.70 至 0.99）。尽管 AD 患者特别容易受到许多旧 AED 相关的不良反应的影响，但他们使用旧 AED 的比例更高。
