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Atypical Antipsychotics Augmentation in Patients with Depressive Disorder and Risk of Subsequent Dementia: A Nationwide Population-Based Cohort Study
- Title
- Atypical Antipsychotics Augmentation in Patients with Depressive Disorder and Risk of Subsequent Dementia: A Nationwide Population-Based Cohort Study
- Authors
- Kim, Jaehyun; Ha, Tae Hyon; Kim, Kiwon; Lee, Eun-Mi; Kim, Hyekyeong; Kim, Doh Kwan; Won, Hong-Hee; Lewis, Matthew; Lee, Hyewon; Myung, Woojae
- Ewha Authors
- 김혜경
- SCOPUS Author ID
- 김혜경
- Issue Date
- 2021
- Journal Title
- JOURNAL OF ALZHEIMERS DISEASE
- ISSN
- 1387-2877
1875-8908
- Citation
- JOURNAL OF ALZHEIMERS DISEASE vol. 80, no. 1, pp. 197 - 207
- Keywords
- Antipsychotic agents; dementia; depression; mood disorders
- Publisher
- IOS PRESS
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background: While atypical antipsychotic medications are widely used for treating depressive disorders, their long-term effects on the risk of subsequent dementia have not been studied adequately. Objective: To investigate whether the risk of dementia differs according to the use of atypical antipsychotic drugs, and compare the effects of antipsychotic agents on dementia risk in individuals with late-life depressive disorders. Methods: A nationwide population-based retrospective cohort study was conducted using data from the National Health Insurance Service-Senior Cohort of South Korea. Atypical antipsychotic dosages were standardized using a defined daily dose, and the cumulative dosage was calculated. Participants were observed from January 2008 to December 2015. Cox proportional hazard regression analysis was used to estimate the hazard ratios. Results: The cohort included 43,788 elderly adults with depressive disorders: 9,901 participants (22.6%) were diagnosed with dementia. Findings showed that atypical antipsychotics were prescribed to 1,967 participants (4.5%). Compared with non-users, users of atypical antipsychotics experienced a significantly higher risk for dementia with an adjusted hazard ratio (aHR) of 1.541 (95% confidence interval [CI], 1.415-1.678). A cumulative dose-response relationship was observed (test for trend, p < 0.0001). Among atypical antipsychotics, risperidone displayed the highest risk for dementia (aHR 1.767, [95% CI, 1.555-2.009]). Conclusion: In this study of elderly individuals with depressive disorders, atypical antipsychotic use was associated with a significantly higher risk of subsequent dementia. Healthcare professionals should be aware of this potential long-term risk. A limitation that should be mentioned is that we could not exclude patients with bipolar depression.
- DOI
- 10.3233/JAD-200994
- Appears in Collections:
- 신산업융합대학 > 융합보건학과 > Journal papers
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