Drug Use before and after Initiating Treatment with Acetylcholinesterase Inhibitors

Background/Aims: The aim was to study the prevalence of use of different drugs prescribed for behavioral and psychological symptoms of dementia in persistent users of acetylcholinesterase inhibitors (AChEIs) before and after AChEI initiation, and to compare with the use in the general population. Me...

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Bibliographic Details
Published in:Dementia and geriatric cognitive disorders extra 2019-01, Vol.9 (1), p.196-206
Main Authors: Efjestad, Anne Sverdrup, Ihle-Hansen, Hege, Hjellvik, Vidar, Engedal, Knut, Blix, Hege Salvesen
Format: Article
Language:English
Subjects:
Age groups
Antidepressants
Apathy
Behavioral and psychological symptoms of dementia
Dementia
Drug use
Evidence-based nursing
Mental depression
Mortality
Nursing homes
Older people
Original
Original Research Article
Pain
Pharmacoepidemiology of dementia
Pharmacotherapy
Population
Prescription drugs
Psychosis
Psychotropic drugs
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Summary:Background/Aims: The aim was to study the prevalence of use of different drugs prescribed for behavioral and psychological symptoms of dementia in persistent users of acetylcholinesterase inhibitors (AChEIs) before and after AChEI initiation, and to compare with the use in the general population. Methods: Use of antidepressants, antipsychotics, and analgesics in the 4 years before and 2 years after AChEI initiation was studied based on data from the Norwegian Prescription Database 2004–2016. Results: The prevalence of use of antidepressants and antipsychotics the year before AChEI initiation was twice the prevalence in the age-adjusted general population and continued to rise in the first 2 years after initiation of AChEIs. The prevalence of weak analgesics and antipsychotics increased strongly in the last year before AChEI initiation. The increase in the use of antidepressants started at least 4 years before initiation of AChEIs. Opioid use was generally lower than in the general population and was not influenced by AChEI initiation. Conclusion: Increased use of antidepressants and antipsychotics was observed both before and after initiation of AChEIs and may indicate that behavioral symptoms occur in a preclinical or early phase of Alzheimer’s disease. The prescription pattern of analgesics with a low use of opioids may indicate an undertreatment of pain in people with dementia.
ISSN:1664-5464
1664-5464
DOI:10.1159/000497307