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Understanding the association between antidepressants and the risk of being diagnosed with dementia in older people: a self-controlled case series study

Xu, Z; Yang, J; Lau, KK; Yip, PSF; Wong, I; Zhang, Q; (2020) Understanding the association between antidepressants and the risk of being diagnosed with dementia in older people: a self-controlled case series study. Journal of Alzheimer's Disease , 78 (2) pp. 735-744. 10.3233/JAD-200875. Green open access

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Abstract

Background: Given concerns about adverse outcomes for older people taking antidepressants in the literature, we investigated whether taking antidepressants elevates the risk of dementia. Objective: This study aims to investigate the putative association of antidepressants with the risk of dementia. Methods: We conducted a population-based self-controlled case series analysis of older people with dementia and taking antidepressants, using territory-wide medical records of 194,507 older patients collected by the Hospital Authority of Hong Kong, to investigate the association between antidepressant treatment and the risk of developing dementia in older people. Results: There was a significantly higher risk of being diagnosed with dementia during the pre-drug-exposed period (incidence rate ratio (IRR) 20.42 (95% CI: 18.66–22.34)) compared to the non-drug-exposed baseline period. The IRR remained high during the drug-exposed period (IRR 8.86 (7.80–10.06)) before returning to a baseline level after washout (IRR 1.12 (0.77–1.36)). Conclusion: The higher risk of dementia before antidepressant treatment may be related to emerging psychiatric symptoms co-occurring with dementia, which trigger medical consultations that result in a decision to begin antidepressants. Our findings do not support a causal relationship between antidepressant treatment and the risk of dementia.

Type: Article
Title: Understanding the association between antidepressants and the risk of being diagnosed with dementia in older people: a self-controlled case series study
Open access status: An open access version is available from UCL Discovery
DOI: 10.3233/JAD-200875
Publisher version: https://doi.org/10.3233/JAD-200875
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Alzheimer’s disease, antidepressants, causal associations, dementia, self-controlled case series studies
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy
URI: https://discovery.ucl.ac.uk/id/eprint/10109247
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