Park C Hyung Keun, Choi Seok-Jin, Kim Ye-Jee, Hong Yoon-Ho, Sung Jung-Joon
Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea.
Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
Muscle Nerve. 2022 Sep;66(3):312-318. doi: 10.1002/mus.27663. Epub 2022 Jul 6.
INTRODUCTION/AIMS: The current status of antidepressant use in patients with amyotrophic lateral sclerosis (ALS), such as the prevalence and factors associated with it, has not been systematically investigated. We aimed to analyze the prevalence and patterns of antidepressant prescriptions in patients with ALS and depression, and to identify factors associated with antidepressant prescriptions after the diagnosis of ALS.
The data of patients with ALS and the prescription of antidepressants were retrieved from the Korean National Health Insurance claims data. A multivariate logistic regression model was used to identify factors associated with antidepressant prescriptions.
In total, 533 of 2955 patients had depressive disorders, and 426 were prescribed antidepressants. Selective serotonin reuptake inhibitors and tricyclic antidepressants were the most frequently prescribed drugs. Adjusted odds ratios (ORs) were 1.379 for the prescription of antidepressants in females. For various age groups, compared with those aged 80 years and older, adjusted ORs were 1.889 for those in their 70s, 2.319 for those in their 60s, 2.872 for those in their 50s, 2.854 for those in their 40s, and 3.363 for those under 40 years of age. Adjusted ORs were 1.662 for patients with a history of a psychiatric disorder and 1.861 for those with a history of psychiatric pharmacotherapy (all P < .05).
Most patients with ALS who had depression received antidepressant prescriptions. In young females with a previous psychiatric disorder or pharmacotherapy, an in-depth evaluation for a depressive disorder should be performed.
引言/目的:肌萎缩侧索硬化症(ALS)患者使用抗抑郁药的现状,如患病率及其相关因素,尚未得到系统研究。我们旨在分析ALS合并抑郁症患者抗抑郁药处方的患病率和模式,并确定ALS诊断后与抗抑郁药处方相关的因素。
从韩国国民健康保险理赔数据中检索ALS患者数据及抗抑郁药处方信息。采用多因素逻辑回归模型确定与抗抑郁药处方相关的因素。
2955例患者中共有533例患有抑郁症,426例患者开具了抗抑郁药处方。选择性5-羟色胺再摄取抑制剂和三环类抗抑郁药是最常开具的药物。女性开具抗抑郁药处方的校正比值比(OR)为1.379。在各年龄组中,与80岁及以上年龄组相比,70多岁患者的校正OR为1.889,60多岁患者为2.319,50多岁患者为2.872,40多岁患者为2.854,40岁以下患者为3.363。有精神疾病史的患者校正OR为1.662,有精神科药物治疗史的患者校正OR为1.861(均P<0.05)。
大多数患有抑郁症的ALS患者接受了抗抑郁药处方。对于有精神疾病或药物治疗史的年轻女性,应进行抑郁症的深入评估。