Antidepressant use at the threshold: people prescribed antidepressants around the time of a dementia diagnosis.

Background Antidepressant use is common in people with dementia, and many start around the time of diagnosis. We hypothesised that those who commenced antidepressants at dementia diagnosis started for dementia-related symptoms, distinct from those with longstanding prescriptions, resulting in differ...

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Publicado en:Age & Ageing Vol. 55; no. 7; pp. 1 - 10
Autores principales: Heybe, Mohamed, Verma, Shreya, Moyano, Beatriz Pozuelo, Stewart, Rob, Mueller, Christoph, Davis, Katrina A S
Formato: Artículo
Publicado: Oxford University Press / USA Jul2026
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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        10.1093/ageing/afag221
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        atl: Antidepressant use at the threshold: people prescribed antidepressants around the time of a dementia diagnosis.
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          Heybe, Mohamed
          Verma, Shreya
          Moyano, Beatriz Pozuelo
          Stewart, Rob
          Mueller, Christoph
          Davis, Katrina A S
        affil:
          Psychological Medicine, King's College London Institute of Psychiatry Psychology & Neuroscience, London, United Kingdom
          Academic Psychiatry, King's College London Institute of Psychiatry Psychology & Neuroscience, London, United Kingdom
          Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, VD, SwitzerlandDepartment of Psychiatry, University of Lausanne, Lausanne, VD, Switzerland
          Psychological Medicine, King's College London Institute of Psychiatry Psychology & Neuroscience, London, United KingdomNIHR Biomedical Research Centre: Maudsley, South London and Maudsley NHS Foundation Trust, London, United Kingdom
          NIHR Biomedical Research Centre: Maudsley, South London and Maudsley NHS Foundation Trust, London, United KingdomDepartment of Old Age Psychiatry, King's College London Institute of Psychiatry Psychology & Neuroscience, London, United Kingdom
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        United Kingdom
        Medical quality control
        Mental health services
        Primary health care
        Anxiety
        Retrospective studies
        Mental depression
        Diagnosis of dementia
        Secondary care (Medicine)
        Research funding
        Multiple regression analysis
        Natural language processing
        Deprescribing
        Chi-squared test
        Descriptive statistics
        Antidepressants
        Longitudinal method
        Odds ratio
        Physician practice patterns
        Electronic health records
        Medical records
        Acquisition of data
        Drug prescribing
        Comparative studies
        Confidence intervals
        Data analysis software
        Dementia patients
      sug:
        subj:
          Medical quality control
          Mental health services
          Primary health care
          Anxiety
          Retrospective studies
          Mental depression
          United Kingdom
          Pharmaceutical and medicine manufacturing
          Medicinal and Botanical Manufacturing
          Offices of Mental Health Practitioners (except Physicians)
          Residential Mental Health and Substance Abuse Facilities
          Psychiatric and Substance Abuse Hospitals
          Diagnosis of dementia
          Secondary care (Medicine)
          Research funding
          Multiple regression analysis
          Natural language processing
          Deprescribing
          Chi-squared test
          Descriptive statistics
          Antidepressants
          Longitudinal method
          Odds ratio
          Physician practice patterns
          Electronic health records
          Medical records
          Acquisition of data
          Drug prescribing
          Comparative studies
          Confidence intervals
          Data analysis software
          Dementia patients
      keyword:
        antidepressive agents
        anxiety
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        dementia
        depression
        depressive disorders
        diagnosis
        electronic health records
        https://dx.doi.org/10.1093/ageing/afag221
        inLanguage:en
        natural language processing
        older people
        prescribing
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/42506890/
        antidepressive agents
        anxiety
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        dementia
        depression
        depressive disorders
        diagnosis
        electronic health records
        https://dx.doi.org/10.1093/ageing/afag221
        inLanguage:en
        natural language processing
        older people
        prescribing
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/42506890/
      ab: Background Antidepressant use is common in people with dementia, and many start around the time of diagnosis. We hypothesised that those who commenced antidepressants at dementia diagnosis started for dementia-related symptoms, distinct from those with longstanding prescriptions, resulting in different characteristics in electronic records. Methods We carried out a retrospective cohort study using linked primary care (Lambeth DataNet) and mental health (Clinical Record Interactive Search) data for patients with dementia in south London, UK in 2009–22. Antidepressant prescription starting within one year before or after dementia diagnosis identified as 'new'. Dementia and anxiety were described using coded fields, a rating scale for neuropsychiatric symptoms and natural language processing of full-text. Results Of 3713 patients with dementia, 28% were prescribed an antidepressant in the year of dementia diagnosis. 42% of these were 'new' prescriptions. Compared to the no antidepressant group, 'new' starters were more likely to be female (odds ratio (OR) 1.33, 95% 1.08–1.64) and have vascular dementia (OR 1.44, 1.13–1.83). Compared to longstanding antidepressant group, 'new' had similar depression and anxiety symptoms, but fewer coded mentions (OR 0.50, 0.39–0.65), especially those 'new' from non-White ethnicities. Deprescribing was equally unlikely in 'new' and longstanding (6.3% vs 5.5% per year of follow-up). Conclusion There is a high prevalence and lack of deprescribing, despite guidelines cautioning antidepressants. This points to unmet needs at the threshold of dementia. Clinicians should ensure good documentation of indication for antidepressants and proactive medication reviews for people with dementia.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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