Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.
Eur Neuropsychopharmacol. 2014 Nov;24(11):1729-37. doi: 10.1016/j.euroneuro.2014.10.004.
Psychotropic drugs are used for treatment of behavioral and psychological symptoms of dementia (BPSD) although they are associated with serious adverse drug events. Objective of our study was to investigate prevalence of psychotropic drug use one year after diagnoses of Alzheimer's disease (AD), to compare prevalence to persons without AD and to assess changes in prevalence over time. Data from the MEDALZ (Medication use and Alzheimer's disease) cohort was utilized in the study including all 69,080 community-dwelling persons with new diagnosis of AD during years 2005-2011 in Finland. Four age-, gender- and region of residence-matched persons without AD were identified for each case. Register-based data included prescription drug purchases and comorbidities from Special Reimbursement Register. Annual prevalence of psychotropic drug use one year after diagnosis was determined for each person. Psychotropic drugs were used by 53% of persons with AD compared with 33% of persons without AD during one year after diagnoses. Persons with AD were six times more likely to use antipsychotics and three times more likely to use antidepressants whereas benzodiazepine and related drug (BZDR) use was comparable between persons with and without AD. According to year of AD diagnoses during 2005-2011, antipsychotic use increased from 18% to 20% (p<0.0001) and BZDR use declined from 31% to 26% (p<0.0001) among persons with AD. Widespread utilization of psychotropic drugs was observed among persons with AD. Despite safety warnings of antipsychotic use for BPSD, antipsychotic use increased from 2005 to 2011 among newly diagnosed persons with AD in Finland.
精神药物用于治疗痴呆的行为和心理症状（BPSD），尽管它们与严重的药物不良事件有关。我们的研究目的是调查阿尔茨海默病（AD）诊断后一年内精神药物使用的流行率，将其与无 AD 的人进行比较，并评估随时间的变化。该研究利用了 MEDALZ（药物使用和阿尔茨海默病）队列的数据，该队列包括芬兰 2005-2011 年期间新诊断的 69080 名居住在社区的 AD 患者。为每个病例确定了 4 名年龄、性别和居住地区匹配的无 AD 患者。基于登记的资料包括从特殊报销登记处获得的处方药物购买和合并症。确定了每个人诊断后一年精神药物使用的年度流行率。AD 患者在诊断后一年中使用精神药物的比例为 53%，而无 AD 的患者为 33%。AD 患者使用抗精神病药物的可能性是无 AD 患者的六倍，使用抗抑郁药的可能性是无 AD 患者的三倍，而 AD 患者和无 AD 患者使用苯二氮䓬类药物和相关药物（BZDR）的比例相当。根据 2005-2011 年 AD 诊断的年份，AD 患者的抗精神病药物使用率从 18%增加到 20%（p<0.0001），BZDR 使用率从 31%下降到 26%（p<0.0001）。AD 患者中广泛使用了精神药物。尽管有关于抗精神病药物用于 BPSD 的安全警告，但芬兰新诊断的 AD 患者中，从 2005 年到 2011 年，抗精神病药物的使用有所增加。
