Incidence of antidepressant drug use in older adults and association with chronic diseases; The Rotterdam Study

Egberts, A.C.G.; Leufkens, Hubert G. M.; Hofman, Albert; Hoes, A. W.

doi:10.1097/00004850-199707000-00006

Cited by 37 publications

(21 citation statements)

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“…However, it has been observed that medication use decreases in those over 75 years [4]. Some suggest that this occurs because: doctors exercise more caution when prescribing to the oldest old [48,49], survivors into advanced age are healthier and thus use fewer medications [4,50], the elderly face fewer stressful events [50]. The observation of a decline in psychotropic drug use with very advancing age is not universal [51]: Blazer et al [6] and Mamdani et al[49] found that it reaches its peak prevalence among those older than 85 years.…”

Section: Resultsmentioning

confidence: 99%

“…Some authors borrowed hypotheses from studies with middle-aged adults to discuss their results [49,53,55,63]. Authors in other studies which found a statistically significant relationship between gender and psychotropic drug use did not discuss or interpret the association [6,48,55,60,64-74]. In sum, many studies confirm that more women than men use psychotropic drugs, but no single compelling explanation for this difference among the aged emerges from this body of studies.…”

Section: Resultsmentioning

confidence: 99%

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Factors associated with psychotropic drug use among community-dwelling older persons: A review of empirical studies

et al. 2004

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BackgroundIn the many descriptive studies on prescribed psychotropic drug use by community-dwelling older persons, several sociodemographic and other factors associated with drug use receive inconsistent support.MethodEmpirical reports with data on at least benzodiazepine or antidepressant drug use in samples of older persons published between 1990 and 2001 (n = 32) were identified from major databases and analyzed to determine which factors are most frequently associated with psychotropic drug use in multivariate analyses. Methodological aspects were also examined.ResultsMost reports used probability samples of users and non-users and employed cross-sectional designs. Among variables considered in 5 or more reports, race, proximity to health centers, medical consultations, sleep complaints, and health perception were virtually always associated to drug use. Gender, mental health, and physical health status were associated in about two-thirds of reports. Associations with age, marital status, medication coverage, socioeconomic status, and social support were usually not observed.ConclusionsThe large variety of methods to operationalize drug use, mental health status, and social support probably affected the magnitude of observed relationships. Employing longitudinal designs and distinguishing short-term from long-term use, focusing on samples of drug users exclusively, defining drug use and drug classes more uniformly, and utilizing measures of psychological well-being rather than only of distress, might clarify the nature of observed associations and the direction of causality. Few studies tested specific hypotheses. Most studies focused on individual characteristics of respondents, neglecting the potential contribution of health care professionals to the phenomenon of psychotropic drug use among seniors.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Factors associated with psychotropic drug use among community-dwelling older persons: A review of empirical studies

et al. 2004

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“…Many medical conditions are associated with a high prevalence of depression (Evans et al 1996;LaghrissiTode et al 1996), and a high incidence of antidepressant drug use (Egberts et al 1997). Chronic treatment with antidepressants, including fluoxetine, has been found to be effective in alleviating the depression associated with multiple sclerosis (Schiffer and Wineman 1990), stroke (Lauritzen et al 1994), HIV infection (Rabkin et al 1994), cancer (Razavi et al 1996), and neurodegenerative diseases (Alexopoulos 1996).…”

Section: Discussionmentioning

confidence: 99%

Effects of Antidepressant Drugs on the Behavioral and Physiological Responses to Lipopolysaccharide (LPS) in Rodents

Yirmiya

Pollak

Barak

et al. 2001

Neuropsychopharmacology

203

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Antidepressants produce various immunomodulatory effects, as well as an attenuation of the behavioral responses to immune challenges, such as lipopolysaccharide (LPS). To explore further the effects of antidepressants on neuroimmune interactions, rats were treated daily with either fluoxetine (Prozac) or saline for 5 weeks, and various behavioral, neuroendocrine, and immune functions were measured following administration of either LPS or saline. Chronic fluoxetine treatment significantly attenuated the anorexia and body weight loss, as well as the depletion of CRH-41 from the median eminence and the elevation in serum corticosterone levels induced by LPS. Chronic treatment with imipramine also attenuated LPS-induced adrenocortical activation. In rats and in mice, which normally display a biphasic body temperature response to LPS (initial hypothermia followed by hyperthermia), chronic treatment with fluoxetine completely abolished the hypothermic response and facilitated and strengthened the hyperthermic response. The effects of antidepressants on the responsiveness to LPS are probably not mediated by their effects on peripheral proinflammatory cytokine production, because LPS-induced expression of TNFSeveral lines of evidence indicate that antidepressants produce various immunomodulatory effects. In depressed patients, the effects of antidepressants are variable and seem to be related to the immune status of the patients at the initiation of the treatment. When depression was associated with immune activation, antidepressants reduced immune function and cytokine secretion. For example, the increased plasma levels of IL-6 during acute depression were normalized by 8-week treatment with fluoxetine (Sluzewska et al. 1995), the increased monocyte counts in depressed patients were reduced following 6-weeks treatment with tricyclic antidepressants (TCAs) (Seidel et al. 1996), and the increased numbers of leukocytes and neutrophils were also reduced by antidepressant treatment (Maes et al. 24 , NO . 5 1997). On the other hand, when immune functions were found to be normal, antidepressants had no immunological effects; for example, chronic moclobemide treatment had no effect on monocytes functions, TNF ␣ production or IFN ␥ levels (Landmann et al. 1997). Moreover, in a study of depressed patients who exhibited immune suppression before treatment, the TCA clomipramine increased the production of IL-1 ␤ , IL-2, and IL-3 (Weizman et al. 1994).In experimental animals, TCAs as well as selective serotonin reuptake inhibitors (SSRIs) produce mainly immune suppression and anti-inflammatory effects. For example, antidepressant treatment in vivo inhibited the increased acute phase response in olfactory bulbectomized rats, a useful animal model of depression (Song and Leonard 1994), reduced the production of interleukin-1 (IL-1) and IL-2 in a chronic mild stress model of depression (Kubera et al. 1996), inhibited immune activation in rats with experimental allergic neuritis (Zhu et al. 1994), and produced anti-inflammatory ...

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“…Specifically, patients with cardiovascular disease appear to have approximately three times the risk for depression, 3,4 those with diabetes mellitus have two to three times the risk, 5 and those with arthritis seem to have 40% to 60% more risk for depression. 6 Depression tends to amplify deleterious effects of medical illness and may even lead to increased mortality. The Systolic Hypertension in the Elderly Program found that depressive symptoms represented a significant risk factor for stroke, myocardial infarction (MI), and death.…”

Section: Depression and Medical Illness : Interrelationshipsmentioning

confidence: 99%

Depression and Medical Illness

Mayberg¹,

Benton²,

Blume³

et al. 2011

Neurobiology of Mental Illness

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Incidence of antidepressant drug use in older adults and association with chronic diseases; The Rotterdam Study

Cited by 37 publications

References 0 publications

Factors associated with psychotropic drug use among community-dwelling older persons: A review of empirical studies

Factors associated with psychotropic drug use among community-dwelling older persons: A review of empirical studies

Effects of Antidepressant Drugs on the Behavioral and Physiological Responses to Lipopolysaccharide (LPS) in Rodents

Depression and Medical Illness

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