Atypical Antipsychotics Augmentation in Patients with Depressive Disorder and Risk of Subsequent Dementia: A Nationwide Population-Based Cohort Study

2021 ◽  
pp. 1-11
Author(s):  
Jaehyun Kim ◽  
Tae Hyon Ha ◽  
Kiwon Kim ◽  
Eun-Mi Lee ◽  
Hyekyeong Kim ◽  
...  
Keyword(s):  
Cohort Study ◽  
Atypical Antipsychotic ◽  
Atypical Antipsychotics ◽  
Depressive Disorders ◽  
Bipolar Depression ◽  
Antipsychotic Agents ◽  
Population Based ◽  
Defined Daily Dose ◽  
Long Term Effects

Background: While atypical antipsychotic medications are widely used for treating depressive disorders, their long-term effects on the risk of subsequent dementia have not been studied adequately. Objective: To investigate whether the risk of dementia differs according to the use of atypical antipsychotic drugs, and compare the effects of antipsychotic agents on dementia risk in individuals with late-life depressive disorders. Methods: A nationwide population-based retrospective cohort study was conducted using data from the National Health Insurance Service—Senior Cohort of South Korea. Atypical antipsychotic dosages were standardized using a defined daily dose, and the cumulative dosage was calculated. Participants were observed from January 2008 to December 2015. Cox proportional hazard regression analysis was used to estimate the hazard ratios. Results: The cohort included 43,788 elderly adults with depressive disorders: 9,901 participants (22.6%) were diagnosed with dementia. Findings showed that atypical antipsychotics were prescribed to 1,967 participants (4.5%). Compared with non-users, users of atypical antipsychotics experienced a significantly higher risk for dementia with an adjusted hazard ratio (aHR) of 1.541 (95% confidence interval [CI], 1.415–1.678). A cumulative dose-response relationship was observed (test for trend, p <  0.0001). Among atypical antipsychotics, risperidone displayed the highest risk for dementia (aHR 1.767, [95% CI, 1.555–2.009]). Conclusion: In this study of elderly individuals with depressive disorders, atypical antipsychotic use was associated with a significantly higher risk of subsequent dementia. Healthcare professionals should be aware of this potential long-term risk. A limitation that should be mentioned is that we could not exclude patients with bipolar depression.

scholarly journals Maternal Childbirth Experience and Time in Labor - A Population-Based Cohort Study

2021 ◽  
Author(s):  
Sara Carlhäll ◽  
Marie Nelson ◽  
Maria Svenvik ◽  
Daniel Axelsson ◽  
Marie Blomberg
Keyword(s):  
Cohort Study ◽  
Clinical Care ◽  
Active Phase ◽  
Population Based ◽  
Long Term Effects ◽  
Negative Effects ◽  
Vas Score ◽  
Childbirth Experience ◽  
Active Labor

Abstract A negative childbirth experience may have long term negative effects on maternal health. New international guidelines allow a slower progress of labor in the early active phase, however a longer time in labor may influence the childbirth experience. In this population-based cohort study including 26,429 women, who gave birth between Jan 2016 to March 2020, the association between duration of the different phases of active labor and childbirth experience was studied. The women assessed their childbirth experience by visual analogue scale (VAS) score. Data including VAS score and labor time estimates were obtained from electronic medical records and adjusted odds ratios (aOR) were calculated.The prevalence of negative childbirth experience (VAS 1-3) was 4,9%. A significant association between longer duration of all phases of active labor and a negative childbirth experience (VAS 1-3) was found for primi- and multipara. The aOR for negative childbirth experience and longer time in active labor in primipara was 1.88, 95% CI (1.59-2.22) and for multipara aOR 1.90, 95% CI (1.59-2.28).It is of great importance to identify and optimize the clinical care of women with prolonged labor to reduce the risk of negative childbirth experience and associated adverse long-term effects.

The long-term effects of stillbirth on women with and without gestational diabetes: a population-based cohort study

Diabetologia ◽  
2014 ◽  
Vol 58 (1) ◽  
pp. 67-74 ◽  
Author(s):  
Basilio Pintaudi ◽  
Giuseppe Lucisano ◽  
Fabio Pellegrini ◽  
Antonio D’Ettorre ◽  
Vito Lepore ◽  
...  
Keyword(s):  
Cohort Study ◽  
Gestational Diabetes ◽  
Population Based ◽  
Long Term Effects

Long term effects of air pollution in Turin, Northern Italy. A population-based cohort study.

2016 ◽  
Vol 2016 (1) ◽  
Author(s):  
Moreno Demaria ◽  
Barbara Lorusso ◽  
Rocco Pispico ◽  
Claudia Galassi ◽  
Nicolas Zengarini ◽  
...  
Keyword(s):  
Air Pollution ◽  
Cohort Study ◽  
Population Based ◽  
Northern Italy ◽  
Long Term Effects

Antipsychotic combination strategies in patients with bipolar disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S615-S615
Author(s):  
R. Molina Ruiz ◽  
M. de Castro Oller ◽  
V. Gomez Macías ◽  
M. Roncero Rodriguez ◽  
F. Montañes Rada
Keyword(s):  
Bipolar Disorder ◽  
Atypical Antipsychotic ◽  
Atypical Antipsychotics ◽  
Treatment Strategies ◽  
Efficacy And Safety ◽  
Long Term Effects ◽  
Combination Strategies ◽  
Affective Symptoms ◽  
Meta Analyses

IntroductionTreatment strategies in bipolar disorder (BPD) has changed in the last decades and polypharmacy including antipsychotics has become extremely common compared to monotherapy with mood stabilisers. Clinicians tend to use 2 or more atypical antipsychotics despite the lack of evidence to support safety, tolerability and efficacy of this practice.ObjectiveTo determine most frequently used treatment strategies in a sample of bipolar disorder patients and review of the literature.MethodologyAnalysis of a sample of 35 patients with BPD from Madrid and review of recent literature for evidence arising from international guidelines recommendations and meta-analyses.ResultsMost frequently used treatment approach in our sample was polytherapy, including at least 1 atypical antipsychotic (31%) and polytherapy, including at least 2 antipsychotics (47%) together with mood stabilisers. Only 11% were in monotherapy with mood stabilisers and another 11%were in monotherapy with one atypical antipsychotic but without mood stabilisers. Aripiprazol and olanzapine were among the most preferred atypical antipsychotics. Efficacy and safety of such combinations have not been systematically compared with monotherapy in the literature. Previous data indicate that polytherapy in BPD may incur in important disadvantages [1].ConclusionsTreatment of BPD remains challenging. Polytherapy seem to have replaced monotherapy due to less relapses and better results in treatment of affective symptoms. However, compliance and secondary long-term effects should be taken into account. Superiority in terms of efficacy in polytherapy needs to be balanced with tolerability issues. More studies on combination therapy, long-term efficacy and safety are needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The Long-Term Effects of Organophosphates Poisoning as a Risk Factor of CVDs: A Nationwide Population-Based Cohort Study

PLoS ONE ◽  
2015 ◽  
Vol 10 (9) ◽  
pp. e0137632 ◽  
Author(s):  
Dong-Zong Hung ◽  
Hao-Jan Yang ◽  
Yu-Fen Li ◽  
Cheng-Li Lin ◽  
Shih-Yu Chang ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Population Based ◽  
Long Term Effects
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