Evaluation of the impact of memantine treatment initiation on psychotropics use: a study from the French national health care database.
BACKGROUND
Clinical studies reported that treatments for Alzheimer's disease may have an impact on behavioral and psychiatric disorders. We tested the hypothesis that memantine treatment initiation modifies psychotropic medication in real-life practice patients.


METHODS
A 2-year follow-up cohort study was performed. A sample of patients treated in the general population, extracted from the database of the French national healthcare system (CNAM-TS), was examined. The sample included 4,600 memantine-treated patients (mean age 79.8 years, 69% women) randomly selected from the database of the CNAM-TS covering 69% of the French population aged 65 years and over. The follow-up rate was 95.0%. This database includes exhaustive data on drug consumption. We used interrupted time series analysis of the proportion of psychotropics users (all psychotropic drugs and specific categories) before and after onset of memantine.


RESULTS
There was a 39-50% regular increase in patients treated with psychotropic drugs before memantine initiation This increasing trend stopped after memantine initiation, the proportion of psychotropic users remaining stable around 53% up to the end. The trends before and after memantine onset were significantly different (p < 0.001).


CONCLUSIONS
Our results suggest a temporal relationship between the onset of memantine and the stabilization of psychotropic drugs use in this large sample of elderly patients.
Vidal
Jean-Sébastien
JS
Institut National de la Santé et de la Recherche Médicale (INSERM-U708), Bordeaux, France.
Lacombe
Jean-Marc
JM
Dartigues
Jean-François
JF
Pasquier
Florence
F
Robert
Philippe
P
Tzourio
Christophe
C
Alpérovitch
Annick
A
D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000191:economics; D014151:Anti-Anxiety Agents / Q000191:economics / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000191:economics / Q000627:therapeutic use; D016208:Databases, Factual; D015259:Dopamine Agents / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D005602:France; D006801:Humans; D006993:Hypnotics and Sedatives / Q000191:economics / Q000627:therapeutic use; D008297:Male; D008559:Memantine / Q000191:economics / Q000627:therapeutic use*; D016202:N-Methylaspartate / Q000037:antagonists & inhibitors; D011619:Psychotropic Drugs / Q000191:economics / Q000627:therapeutic use*; D016896:Treatment Outcome
D014151:Anti-Anxiety Agents; D014150:Antipsychotic Agents; D015259:Dopamine Agents; D006993:Hypnotics and Sedatives; D011619:Psychotropic Drugs; D016202:N-Methylaspartate; D008559:Memantine