Comparative effectiveness of antidepressants on geriatric depression: Real-world evidence from a population-based study

Chih Wei Hsu, Wei Ting Tseng, Liang Jen Wang, Yao Hsu Yang, Hung Yu Kao, Pao Yen Lin

研究成果: Article同行評審

21 引文 斯高帕斯(Scopus)

摘要

Background: There is little real-world evidence about effectiveness of different antidepressants on geriatric depression. Methods: We used population-based claims data in Taiwan between 1997 and 2013 to include older patients (≥ 60 years of age) who were diagnosed with depression and started to use antidepressants. All patients were followed up until discontinuation of antidepressant use or the end of the study period. Treatment outcomes were set as the risk of switching to another antidepressant, receiving augmentation therapy, and psychiatric hospitalization. We used cox proportional hazards regression models to calculate hazard ratios with 95% confidence intervals (CIs) and adjust for several confounding factors (aHRs). Results: During the study period, a total of 207,946 elderly patients with depression received one of the following 11 antidepressants: sertraline, fluoxetine, paroxetine, escitalopram, citalopram, fluvoxamine, venlafaxine, duloxetine, moclobemide, mirtazapine, and bupropion. Compared to the patients treated with sertraline, those treated with fluvoxamine / venlafaxine had significantly but modestly higher risks of switching (aHR [95% CI]: 1.16 [1.11–1.21] / 1.10 [1.06–1.14]), augmentation (1.06 [1.02–1.10] / 1.08 [1.05–1.12]), and hospitalization (1.28 [1.03–1.58] / 1.37 [1.16–1.62]). Otherwise, the remaining 9 antidepressants yielded no consistent result in the three outcomes. Limitations: This study is a multi-arm and active controlled trial, lacking a placebo group. Conclusion: As treating geriatric depression, no individual antidepressant posed consistently better effectiveness in the outcomes of switching antidepressant, receiving augmentation, and psychiatric hospitalization than any other one, whereas clinicians should be cautious when prescribing fluvoxamine and venlafaxine.

原文English
頁(從 - 到)609-615
頁數7
期刊Journal of Affective Disorders
296
DOIs
出版狀態Published - 2022 1月 1

All Science Journal Classification (ASJC) codes

  • 臨床心理學
  • 精神病學和心理健康

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