Psychotropic Drugs in Patients With Alzheimer's Disease: A Longitudinal Study by the Registry of Dementias of Girona (ReDeGi) in Catalonia, Spain

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• 作者：Laia Calvó ; -Perxas ; PhD^a ; Oriol Turró ; -Garriga ; BPsych^a ; ^{recerca@ias.scs.es" class="auth_mail} ; Maria Aguirregomozcorta ; MD^b ; Josep Bisbe ; MD^c ; Eré ; lido Herná ; ndez ; MD^d ; Secundino Ló ; pez-Pousa ; PhD^a ; ^e ; ^f ; Anna Manzano ; MD^g ; Mó ; nica Palacios ; BPharm^h ; Imma Pericot-Nierga ; PhD^e ; Hé ; ctor Perkal ; MDⁱ ; Lluí ; s Ramió ; MD^j ; Joan Vilalta-Franch ; PhD^a ; ^e ; ^f ; Josep Garre-Olmo ; PhD^a ; ^f ; on behalf of the Registry of Dementias of Girona Study Group (ReDeGi Study Group) Mar Castellanos ; PhD ; David Gení ; s Batlle ; MD ; Jordi Gich ; PhD ; Albert Molins ; MD ; Lluí ; s Ramió ; MD ; Joaquí ; n Serena ; PhD ; Yolanda Silva ; PhD
• 关键词：Drug prescription ; dementia ; Alzheimer's disease ; Antipsychotics ; SSRI ; anxiolytics
• 刊名：Journal of the American Medical Directors Association
• 出版年：July 2014
• 年：2014
• 卷：15
• 期：7
• 页码：497-503
• 全文大小：465 K

文摘

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.