抗抑郁药老年使用者中痴呆风险:西班牙基于人口的队列分析
Javier Santandreu1, Francisco Félix Caballero2, M Pilar Gómez-Serranillos1
1Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Universidad Complutense de Madrid, Madrid, Spain.
Journal of affective disorders
|January 9, 2024
概括
使用选择性血清素再吸收抑制剂 (SSRI) 和其他抗抑郁药 (OA) 的老年人与使用三环抗抑郁药 (TCA) 的人相比,面临更高的痴呆风险. 这项研究强调了与老年人群中的某些抗抑郁药类相关的潜在风险.
科学领域:
- 老年学是一门学科.
- 神经科学是一个神经科学.
- 药学流行病学 药学流行病学
背景情况:
- 老年人使用抗抑郁药是常见的,一些类与痴呆风险有关.
- 关于特定类型抗抑郁药与痴呆症之间的关联现有研究是相互矛盾的.
研究的目的:
- 为了比较老年患者的痴呆风险,处方三环抗抑郁药 (TCA) 与选择性血清素再吸收抑制剂 (SSRI) 和其他抗抑郁药 (OA) 相比.
主要方法:
- 一项基于人口的前性队列研究利用了西班牙制药流行病学数据 (2005-2018).
- 包括62,928名60岁以上没有痴呆症的长期单一治疗的患者.
- 使用考克斯回归和卡普兰-梅尔模型分析痴呆风险.
主要成果:
- 与TCA使用者相比,SSRI使用者患痴呆的风险明显高 (HR=1.864).
- 与TCA (HR=2.103) 相比,其他抗抑郁药 (OA) 用户也表现出明显的痴呆风险.
结论:
- 使用SSRI和OA的老年人与TCA使用者相比,患痴呆症的风险较高.
- 需要进一步的研究来证实这些发现,并探索潜在的机制.
相关概念视频
Antidepressant Drugs: MAOIs and Other Agents
237
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
237
Antidepressant Drugs: Overview
493
Antidepressant drugs are a class of medications primarily used for treating various mood disorders, including major depression, anxiety disorders, and other related conditions. These medicines work by modulating the neurotransmitter balance within the brain, alleviating depressive symptoms. Antidepressants can be broadly categorized into several groups according to their mechanism of action and chemical structure: Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine...
493
Dementia
115
Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
The progression of dementia is generally gradual....
The progression of dementia is generally gradual....
115
Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs
394
Tricyclic Antidepressants (TCAs), including Desipramine (Norpramin), Imipramine (Tofranil), Clomipramine (Anafranil), and Amitriptyline (Elavil), inhibit serotonin and norepinephrine reuptake and also block other receptors. They are used for depression, pain conditions, and insomnia. Common adverse effects include anticholinergic effects, sedation, orthostatic hypotension, and weight gain. They have a narrow therapeutic window and so require plasma-level monitoring. Abrupt discontinuation can...
394
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
148
The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
A study on guinea pigs examined the...
148
Anxiolytic Drugs: Benzodiazepines and Buspirone
776
Benzodiazepines are a class of anxiolytic drugs known for their rapid efficacy and high therapeutic-to-lethal dose ratio, but with a potential risk of drug dependence. These drugs are lipophilic, allowing for rapid absorption after oral administration, eventually reaching the central nervous system (CNS). Once in the CNS, benzodiazepines bind to the allosteric site of the GABAA receptor. This binding enhances the inhibitory effects of the neurotransmitter GABA. By doing so, they prevent...
776


