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德国普通或精神科诊所中接受抗抑郁药治疗的患者患痴呆症的风险

Risk of dementia in German patients treated with antidepressants in general or psychiatric practices
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作者信息

Jacob Louis, Bohlken Jens, Kostev Karel

出版信息

Int J Clin Pharmacol Ther. 2017 Apr;55(4):322-328. doi: 10.5414/CP202754.

Abstract

AIMS

To study the impact of the use of antidepressants on dementia in German patients with depression treated in general (GPs) or psychiatric practices (PPs).

METHODS

Patients with a first-time documentation of depression with known severity level between 2010 and 2013 (index date) were identified by 1,126 general practitioners and 176 psychiatrists in the IMS Disease Analyzer database. We included patients between the ages of 60 and 80 years who had not previously received prescriptions for antidepressant drugs and had not been diagnosed with all-cause dementia prior to or on the index date. The main outcome of the study was the risk of dementia depending on antidepressant therapy. Cox proportional hazards models (dependent variable: incident dementia) were used to adjust for confounders and to estimate the effect of antidepressant therapy.

RESULTS

A total of 22,838 patients treated in GPs and 33,112 patients treated in PPs were included in this study. Of those, 9,570, 30,321, and 16,059 individuals suffered from mild, moderate, and severe depression, respectively. Antidepressant drug use was associated with a decreased risk of dementia in patients affected by moderate (HR = 0.86, 95% CI: 0.77 - 0.95) or severe depression (HR = 0.83, 95% CI: 0.73 - 0.94).

CONCLUSION: The use of antidepressants decreased dementia risk in patients with moderate or severe depression.
.

摘要

目的

研究在德国普通全科医生诊所(GPs)或精神科诊所(PPs)接受治疗的抑郁症患者中,使用抗抑郁药对痴呆症的影响。

方法

在IMS疾病分析数据库中,由1126名全科医生和176名精神科医生识别出2010年至2013年期间首次记录有已知严重程度的抑郁症患者(索引日期)。我们纳入了年龄在60至80岁之间、此前未接受过抗抑郁药物处方且在索引日期之前或当日未被诊断患有全因性痴呆症的患者。该研究的主要结果是取决于抗抑郁治疗的痴呆症风险。使用Cox比例风险模型(因变量:新发痴呆症)来调整混杂因素并估计抗抑郁治疗的效果。

结果

本研究共纳入了22838名在普通全科医生诊所接受治疗的患者和33112名在精神科诊所接受治疗的患者。其中,9570人、30321人和16059人分别患有轻度、中度和重度抑郁症。在患有中度(HR = 0.86,95% CI:0.77 - 0.95)或重度抑郁症(HR = 0.83,95% CI:0.73 - 0.94)的患者中,使用抗抑郁药与痴呆症风险降低相关。

结论

使用抗抑郁药可降低中度或重度抑郁症患者的痴呆症风险。

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