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. 2023 May-Jun:82:66-74.
doi: 10.1016/j.genhosppsych.2023.03.009. Epub 2023 Mar 22.

Concurrent use of polypharmacy and potentially inappropriate medications with antidepressants in older adults: A nationwide descriptive study in Denmark during 2015-2019

Kazi Ishtiak-Ahmed  1 , Ole Köhler-Forsberg  2 , Erik Lykke Mortensen  3 , Andrew A Nierenberg  4 , Christiane Gasse  5
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Free article

Concurrent use of polypharmacy and potentially inappropriate medications with antidepressants in older adults: A nationwide descriptive study in Denmark during 2015-2019

Kazi Ishtiak-Ahmed et al. Gen Hosp Psychiatry. 2023 May-Jun.
Free article

Abstract

Objective: Concurrent polypharmacy and potentially-inappropriate-medication (PIMs) use with antidepressants in older adults is understudied. We investigated the prevalence and associated user characteristics of concurrent polypharmacy (≥5 drugs) and PIMs with antidepressants in all older adults (≥65 years) in Denmark based on prescriptions filled at community pharmacies during 2015-2019.

Method: We applied a cross-sectional and cohort study design using socio-demographic and clinical data from Danish registers.

Results: A total of 261,479 older adults (mean age 76 years, females 63%) redeemed at least one prescription of antidepressants during 2015-2019. The prevalence of polypharmacy was 73%, and PIMs was 56%, with over 80% using at least one other nervous system drug or cardiovascular system drug concomitantly with antidepressants. Characteristics associated with higher concurrent use of polypharmacy and PIM with antidepressants were older age, marital status as widow/widower/separated/single, place of residence predominantly in the rural regions, non-western origin, and having somatic diagnoses. Some characteristics showed opposite directions of the associations with the two outcomes, including previous antidepressant use and psychiatric diagnoses being associated with higher use of polypharmacy but lower use of PIM.

Conclusion: High polypharmacy and PIM use with antidepressants underline the importance of regularly reviewing pharmacological treatments in older adults with depression.

Keywords: Comorbid depression; Depression in primary care; General practitioner; Geriatric depression management; Inequality in geriatric mental health; Socially disadvantaged older adults.

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Conflict of interest statement

Declaration of Competing Interest KI, ELM, CG declare no conflict of interest. OKF reports honoraria for lectures for Lundbeck Pharma A/S and consultant fees for WCG Clinical, all unrelated to the present work. AAN is a consultant for Alkermes, Clexio, Ginger/Headspace Health, Janssen, Merk, Neuronetics, NeuroRx, Otsuka, Protagenics, SAGE, Sunovion, Unravel Bioscience, received honoraria from Belvior, EISAI, Psychiatric Annals Slack Publications, Wiley Depression and Anxiety, received royalties from Guilford Publications, Up-to-Date Wolters Kluwer Health, has been a scientific advisory board member for Altimate, Flow, Milken Center for Strategic Philanthropy, Myriad Bipolar, and adjudication committee member for Novartis.

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