title: Antidepressants and risk of dementia in migraine patients: A population-based case-control study.
abstract: To ascertain the relationship between receipt of antidepressant agents and the risk of subsequent dementia in migraine patients. A population-based case-control analysis, using the Taiwan National Health Insurance Research Database. We identified 1774 patients with dementia and 1774 matched nondementia controls from migraine patients enrolled in the Taiwan National Health Insurance program between 2005 and 2011. The proportional distributions of exposure to three classes of antidepressant were compared between dementia and nondementia groups. Univariable and multivariable logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of dementia based on antidepressant exposure. The proportions of subjects taking tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and new-generation antidepressants (NGAs) in dementia versus nondementia groups are 52.3 vs 51.2%, 25.5 vs 30.7%, and 18.8 vs 6.26%, respectively. The adjusted ORs of dementia were 1.02 (95% CI=0.89, 1.17; P=0.56) for TCAs, 0.58 (95% CI=0.50, 0.69; P<0.001) for SSRIs, and 4.23 (95% CI=3.34, 5.37; P<0.001) for NGAs. Treatment with SSRIs was associated with a decreased risk of dementia in migraine patients. TCAs showed no association with dementia risk, and NGAs showed increased risk. Given the possibility of confounding by indication, additional prospective trials and basic research are needed before drawing conclusions about the population-level risks for dementia onset conferred by antidepressant medications.
authors.affiliation: Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan.
authors.forename: Cynthia Wei-Sheng
authors.initials: CW
authors.lastname: Lee
authors.affiliation: Management Office for Health Data, China Medical University Hospital, China Medical University, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Department of Psychiatry and Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Neural and Cognitive Sciences, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Pan-Yen
authors.initials: PY
authors.lastname: Lin
authors.affiliation: Geriatric Research, Education, and Clinical Center, Puget Sound VA Medical Center, Seattle, WA, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Thielke
authors.affiliation: Department of Psychiatry and Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Neural and Cognitive Sciences, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Kuan-Pin
authors.initials: KP
authors.lastname: Su
authors.affiliation: Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan; Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D016208:Databases, Factual; D003704:Dementia / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy* / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressants; Case-control study; Dementia; Migraine; SSRI; Tricyclic