Depression

Schwarz, Štefan; Frölich, Lutz

doi:10.1007/978-3-7091-0912-0_16

Cited by 1 publication

(2 citation statements)

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“…Although the elderly have the highest exposure to antidepressants, limited data are available to justify their use in this vulnerable population. They are usually excluded from randomized controlled trials [4] and meta‐analyses show small effect sizes for antidepressants compared to placebo with no substantial efficacy difference between antidepressant classes [4–6]. Considering their favorable tolerability, guidelines recommend selective serotonin reuptake inhibitors (SSRIs) as first‐line therapy for depression, reflecting results from randomized controlled trials in younger adults [6].…”

Section: Introductionmentioning

confidence: 99%

“…Considering their favorable tolerability, guidelines recommend selective serotonin reuptake inhibitors (SSRIs) as first‐line therapy for depression, reflecting results from randomized controlled trials in younger adults [6]. Age‐related polypharmacy, multimorbidity and physiological changes affecting drug metabolism and action in the elderly make such an extrapolation problematic [4].…”

Section: Introductionmentioning

confidence: 99%

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Antidepressant use and stroke or mortality risk in the elderly

Ön

Vidal

Berger

et al. 2021

Euro J of Neurology

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Background and purpose: Current evidence on antidepressant-related stroke or mortality risk is inconsistent. Because the elderly have the highest exposure to antidepressants, the aim was to quantify their association with stroke and mortality risks in this vulnerable population. Methods: Persons over 65 years old and registered in the Information System for Research in Primary Care of Catalonia during 2010-2015 comprised the study population. Antidepressant exposure was categorized into current-users, recent-users, pastusers and antidepressant non-users (controls). The effect of antidepressant exposure on stroke or death, whichever came first, was analyzed by Cox regression adjusted for established risk factors. Results:Of the 1,068,117 participants included, 20% had antidepressant reimbursements during follow-up, 17% had a stroke and 3% died. The risk of experiencing stroke or death was higher in antidepressant current-users (hazard ratio [HR] 1.04; 95% confidence interval [CI] 1.02-1.06), recent-users (HR 3.34;) and past-users (HR 2.06; 95% CI 2.02-2.10) compared to antidepressant non-users. Antidepressant current-use was associated with increased stroke (HR 1.56; 95% CI 1.50-1.61) but decreased mortality risk (HR 0.93; 95% CI 0.91-0.94). During antidepressant recent-use and past-use, both stroke and mortality risks were significantly increased compared to no antidepressant use.Conclusions: Antidepressant use may be associated with increased stroke risk in the elderly. When using antidepressants in this population, the potential risks should be considered.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%