title: Lifestyle factors, psychiatric and neurologic comorbidities, and drug use associated with incident seizures among adult patients with depression: a population-based nested case-control study.
abstract: To investigate risk factors for incident seizures among adult patients with depression. We conducted a nested case-control analysis in adult patients with newly diagnosed depression, using data from the U.K.-based Clinical Practice Research Datalink. Among cases with incident seizures and matched controls, we estimated odds ratios (ORs) with 95 % confidence intervals (CIs) of potential risk factors for seizures as reported from data of the general population: underweight (body mass index <18.5 kg/m2), smoking, alcoholism, drug abuse, psychiatric or neurologic comorbidities, and concomitant use of drugs. Of 186,540 patients with depression, 1489 developed a seizure during follow-up. Being underweight (OR 1.67 [95 % CI 1.23-2.26]), a current smoker (OR 1.45 [95 % CI 1.26-1.67]), having alcoholism (OR 2.98 [95 % CI 2.56-3.47]), and drug abuse (OR 2.51 [95 % CI 1.94-3.24]), were associated with increased risks of seizures compared to normal weight, non-smoking, no alcoholism, and no drug abuse, respectively. Previous stroke/transient ischemic attack (OR 6.07 [95 % CI 4.71-7.83]) or intracerebral bleeding (OR 8.19 [95 % CI 4.80-13.96]), and comorbid dementia (OR 6.83 [95 % CI 4.81-9.69]), were strongly associated with seizures. Current use of cephalosporins (OR 2.47 [95 % CI 1.61-3.78]) and antiarrhythmics (OR 1.59 [95 % CI 1.26-2.01]) was associated with an increased risk of seizures compared to non-use. Among adult patients with depression, being underweight, smoking, alcoholism, and drug abuse, were associated with seizures. Remote stroke and comorbid dementia were strong risk factors for seizures. Current use of cephalosporins or antiarrhytmics was associated with an increased risk of seizures compared to non-use.
authors.affiliation: Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
authors.forename: Marlene
authors.initials: M
authors.lastname: Bloechliger
authors.affiliation: National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland.|Division of Clinical Pharmacology and Toxicology, Department of Internal Medicine, Ente Ospedaliero Cantonale, Lugano, Switzerland.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ceschi
authors.affiliation: Division of Clinical Neurophysiology, Department of Neurology, University Hospital Basel, Basel, Switzerland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Rüegg
authors.affiliation: Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA, USA.
authors.forename: Susan Sara
authors.initials: SS
authors.lastname: Jick
authors.affiliation: Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland. christoph.meier@usb.ch.|Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA, USA. christoph.meier@usb.ch.|Hospital Pharmacy, University Hospital Basel, Spitalstrasse 26, 4031, Basel, Switzerland. christoph.meier@usb.ch.
authors.forename: Christoph Rudolf
authors.initials: CR
authors.lastname: Meier
authors.affiliation: Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.|Medical Department, Zuger Kantonsspital, Zug, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Bodmer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000453:epidemiology* / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Depression; Depressive disorder; Risk factors; Seizures