Laia Calvó-Perxas1, Oriol Turró-Garriga2, Maria Aguirregomozcorta3, Josep Bisbe4, Erélido Hernández5, Secundino López-Pousa6, Anna Manzano7, Mónica Palacios8, Imma Pericot-Nierga9, Héctor Perkal10, Lluís Ramió11, Joan Vilalta-Franch6, Josep Garre-Olmo12. 1. Institute of Biomedical Investigation of Girona (IdIBGi), IAS Research Unit, Salt, Catalonia, Spain. 2. Institute of Biomedical Investigation of Girona (IdIBGi), IAS Research Unit, Salt, Catalonia, Spain. Electronic address: recerca@ias.scs.es. 3. Neurology Unit, Hospital de Figueres, Figueres, Catalonia, Spain. 4. Neurology Department, Hospital d'Olot, Olot, Catalonia, Spain. 5. Dementia Unit, Serveis de Salut Integrats del Baix Empordà, Palamós, Catalonia, Spain. 6. Institute of Biomedical Investigation of Girona (IdIBGi), IAS Research Unit, Salt, Catalonia, Spain; Dementia Unit, Hospital de Santa Caterina, Salt, Catalonia, Spain; Department of Medicine, University of Girona, Girona, Catalonia, Spain. 7. Neurology Department, Hospital de Campdevànol, Campdevànol, Catalonia, Spain. 8. Pharmacy Unit, Health Region of Girona, Girona, Catalonia, Spain. 9. Dementia Unit, Hospital de Santa Caterina, Salt, Catalonia, Spain. 10. Geriatrics and Neurology Department, Hospital de Blanes, Blanes, Catalonia, Spain. 11. Neurodegenerative Disease Unit, Hospital Universitari Dr. Josep Trueta, Girona, Catalonia, Spain. 12. Institute of Biomedical Investigation of Girona (IdIBGi), IAS Research Unit, Salt, Catalonia, Spain; Department of Medicine, University of Girona, Girona, Catalonia, Spain.
Abstract
OBJECTIVES: Psychotropic drugs are usually prescribed to deal with behavioral and psychological symptoms of dementia, especially when nonpharmacologic approaches are not available or have limited efficacy. Poor outcomes and serious adverse events of the drugs used must be addressed, and risk-benefit ratios need to be considered. The aim of this longitudinal study was to describe the evolution of dispensation of psychotropic drugs in patients with Alzheimer's disease (AD) and to identify the associated demographic and clinical variables. METHODS: Longitudinal study using 698 cases with AD included in the Registry of Dementias of Girona in 2007 and 2008 and followed up during 3 years. Drugs were categorized according to the Anatomical Therapeutic Chemical classification. Binary logistic regression analyses were used to detect the variables associated with the use of antipsychotics, selective serotonin reuptake inhibitors (SSRIs), anxiolytics, and hypnotics. RESULTS: Of the patients, 51.2% consumed antipsychotics at least once during the three years of the study, whereas 73.3% and 58.2% consumed SSRIs and anxiolytics, respectively; 32.8% used hypnotics. Antipsychotic use was associated with a diagnosis of AD with delusions) [odds ratio (OR) = 5.7] and with increased behavior disorders (OR = 1.2). Patients with AD with depressed mood were more likely to be treated with SSRIs (OR = 3.1), while being a woman was associated with increased dispensation of anxiolytics (OR = 1.9) and SSRIs (OR = 2.2). CONCLUSIONS: Consumption of psychotropic drugs by the patients with AD registered in the Registry of Dementias of Girona is very high. Despite all the described adverse effects and recommendations of caution in their use, antipsychotics still are extensively used.
OBJECTIVES: Psychotropic drugs are usually prescribed to deal with behavioral and psychological symptoms of dementia, especially when nonpharmacologic approaches are not available or have limited efficacy. Poor outcomes and serious adverse events of the drugs used must be addressed, and risk-benefit ratios need to be considered. The aim of this longitudinal study was to describe the evolution of dispensation of psychotropic drugs in patients with Alzheimer's disease (AD) and to identify the associated demographic and clinical variables. METHODS: Longitudinal study using 698 cases with AD included in the Registry of Dementias of Girona in 2007 and 2008 and followed up during 3 years. Drugs were categorized according to the Anatomical Therapeutic Chemical classification. Binary logistic regression analyses were used to detect the variables associated with the use of antipsychotics, selective serotonin reuptake inhibitors (SSRIs), anxiolytics, and hypnotics. RESULTS: Of the patients, 51.2% consumed antipsychotics at least once during the three years of the study, whereas 73.3% and 58.2% consumed SSRIs and anxiolytics, respectively; 32.8% used hypnotics. Antipsychotic use was associated with a diagnosis of AD with delusions) [odds ratio (OR) = 5.7] and with increased behavior disorders (OR = 1.2). Patients with AD with depressed mood were more likely to be treated with SSRIs (OR = 3.1), while being a woman was associated with increased dispensation of anxiolytics (OR = 1.9) and SSRIs (OR = 2.2). CONCLUSIONS: Consumption of psychotropic drugs by the patients with AD registered in the Registry of Dementias of Girona is very high. Despite all the described adverse effects and recommendations of caution in their use, antipsychotics still are extensively used.
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