title: Antidepressant treatment and risk of dementia: a population-based, retrospective case-control study.
abstract: OBJECTIVE
  We investigated the relationship between antidepressant use and the risk of subsequent dementia development.
  
  
  METHODS
  A population-based retrospective case-control analysis was conducted using the Taiwan National Health Insurance Research Database. From patients enrolled in the National Health Insurance program between 2005 and 2011, we identified 2 subsets: 5,394 cases, who had major depression in 1997-2004 and subsequently were diagnosed with dementia (ICD-9-CM code 290) in 2005-2011, and 5,232 controls, who had major depression in 2005-2011 but no dementia history. The proportional distributions of antidepressant use and comorbidities in the dementia case and nondementia control groups were compared. Univariable and multivariable logistic regression analyses were used to estimate the odds ratios (ORs) and 95% CIs for the association between dementia and antidepressant use.
  
  
  RESULTS
  The dementia patients were more likely to have diabetes, hypertension, stroke, and head injury. The adjusted OR for dementia was 0.24 (95% CI, 0.22-0.27) in patients using tricyclics . By contrast, the use of selective serotonin reuptake inhibitors (SSRIs) (OR = 2.48; 95% CI, 2.27-2.71), monoamine oxidase inhibitors (MAOIs) (OR = 1.86; 95% CI, 1.47-2.36), heterocyclic antidepressants (OR = 1.44; 95% CI, 1.32-1.57), and other antidepressants (OR = 2.05; 95% CI, 1.85-2.27) was associated with an increased risk of dementia. Furthermore, as the cumulative dose was increased, tricyclic antidepressants reduced the risk of dementia, whereas SSRIs, MAOIs, heterocyclic antidepressants, and other antidepressants increased the risk of dementia.
  
  
  CONCLUSIONS
  The incidence of dementia in patients is associated with antidepressant medication use. Treatment with tricyclic antidepressants was associated with a reduced risk of dementia, whereas treatment with SSRIs, MAOIs, heterocyclic antidepressants, and other antidepressants was associated with an increased risk of dementia.
authors: Center for Drug Abuse and Addiction, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.
authors: Cynthia Wei-Sheng
authors: CW
authors: Lee
authors: Cheng-Li
authors: CL
authors: Lin
authors: Fung-Chang
authors: FC
authors: Sung
authors: Ji-An
authors: JA
authors: Liang
authors: Chia-Hung
authors: CH
authors: Kao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D016208:Databases, Factual; D003704:Dementia / Q000139:chemically induced* / Q000150:complications*; D003865:Major Depressive Disorder / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan
chemical_list: D000928:Antidepressive Agents