Antidepressant use and stroke or mortality risk in the elderly
Ön, Begüm Irmak (Institute for Medical Information Processing. Biometry and Epidemiology. LMU Munich)
Vidal Guitart, Xavier (Hospital Universitari Vall d'Hebron)
Berger, Úrsula (Institute for Medical Information Processing. Biometry and Epidemiology. LMU Munich)
Sabaté, Mònica (Vall d'Hebron Institut de Recerca (VHIR))
Ballarín, Elena (Vall d'Hebron Institut de Recerca (VHIR))
Maisterra Santos, Olga (Hospital Universitari Vall d'Hebron)
San-Jose, Antonio (Hospital Universitari Vall d'Hebron)
Ibáñez, Luisa (Vall d'Hebron Institut de Recerca (VHIR))

Data:	2021
Resum:	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, past-users 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; 95% CI 3. 27-3. 41) 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.
Ajuts:	Ministerio de Economía y Competitividad PI15/01429
Nota:	Altres ajuts: acords transformatius de la UAB
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Aged ; Antidepressive agents ; Mortality ; Pharmacoepidemiology ; Stroke
Publicat a:	European Journal of Neurology, Vol. 29 (2021) , p. 469-477, ISSN 1468-1331

DOI: 10.1111/ene.15137
PMID: 34632668

11 p, 1.8 MB

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