Use and risks of antidepressants and antipsychotics particularly in the elderly

Antidepressants and antipsychotics are crucial for the treatment of psychological disorders. However, some of these drugs have been associated with an increased risk of adverse drug reactions. Since use of antidepressants and antipsychotics has been growing steadily in recent years, the necessity for the assessment of risks of adverse drugs reactions on the individual drug level has increased.

In close collaboration with the Epidemiology of Neuropsychiatric Disorders Unit the Drug Safety Unit investigates the safety and utilization of antidepressants and antipsychotics. The German Pharmacoepidemiological Research Database (GePaRD) serves as the data source for the conduct of studies in this area. The research is focused on the investigation of safety and use of antidepressants and antipsychotics in the elderly, as this patient population is more vulnerable to adverse drug reactions due to chronic health conditions and declining kidney function.

Third-party funding

Pharmacoepidemiological safety study of neuroleptics and antidepressants in the area of geriatric psychiatrics (PhaSiNAg), Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM), 11/2012-08/2015

Related projects

  • Pharmacoepidemiological safety study of neuroleptics and antidepressants in the area of geriatric psychiatrics (PhaSiNAg)
  • Post-authorization safety study on agomelatine and the risk of hospitalization for acute liver injury (Agomelatine)
  • Post-authorization safety study (PASS) on extrapyramidal symptoms in patients treated with Abilify Maintena® in Germany (Aripripazole)
  • Arrhythmogenic potential of drugs (ARITMO)

 

Theses

  • Antidepressiva Off-Label-Use und palliative Versorgung bei älteren Menschen, Master's thesis Epidemiology MSc, Wiebke Schäfer (01/2017, completed)
  • Atypical antipsychotic drug use and the risk for acute kidney injury in the elderly, Master's thesis Epidemiology MSc, Nadine Schlie (02/2017, completed)

 

Selected publications

  • Jobski K, Schmedt N, Kollhorst B, Krappweis J, Schink T, Garbe E. Characteristics and drug use patterns of older antidepressant initiators in Germany. European Journal of Clinical Pharmacology. 2017;73:105-113. dx.doi.org/10.1007/s00228-016-2145-7
  • Oteri A, Mazzaglia G, Pecchioli S, Molokhia M, Ulrichsen SP, Pedersen L, Poluzzi E, De Ponti F, Garbe E, Schink T, Herings R, Bezemer I, Sturkenboom MCJM, Trifirò G. Prescribing pattern of antipsychotic drugs during the years 1996-2010: A population-based database study in Europe with a focus on torsadogenic drugs. British Journal of Clinical Pharmacology. 2016;82(2):487-497. dx.doi.org/10.1111/bcp.12955
  • Schmedt N, Jobski K, Kollhorst B, Krappweis J, Schink T, Rüther E, Garbe E. Treatment patterns and characteristics of older antipsychotic users in Germany. International Clinical Psychopharmacology. 2016;31(3):159-169. dx.doi.org/10.1097/YIC.0000000000000119
  • Schmedt N, Kollhorst B, Enders D, Jobski K, Krappweis J, Garbe E, Schink T. Comparative risk of death in older adults treated with antipsychotics: A population-based cohort study. European Neuropsychopharmacology. 2016;26(9):1390-1400. dx.doi.org/10.1016/j.euroneuro.2016.07.006
  • Dörks M, Langner I, Dittmann U, Timmer A, Garbe E. Antidepressant drug use and off-label prescribing in children and adolescents in Germany: Results from a large population-based cohort study. European Child & Adolescent Psychiatry. 2013;22(8):511-518. dx.doi.org/10.1007/s00787-013-0395-9
  • Schmedt N, Garbe E. Antipsychotic drug use and the risk of venous thromboembolism in elderly patients with dementia. Journal of Clinical Psychopharmacology. 2013;33(6):753-758. http://dx.doi.org/10.1097/JCP.0b013e3182a412d5

 

Selected presentations

  • Pisa FE, Reinold J, Kollhorst B, Haug U, Schink T. Risk of Traumatic Brain Injury in Elderly New Users of Antidepressants. ICPE 34th International Conference on Pharmacoepidemiology and Therapeutic Risk Management. August 22-26, 2018, Prague, Czech Republic (oral presentation). Pharmacoepidemiol Drug Saf (2018) 27(S2): 20. http://doi.org/10.1002/pds.4629
  • Pisa FE, Reinold J, Kollhorst B, Haug U, Schink T. Association of individual antidepressants and hip fracture in older adults: a cohort study with nested case-control analysis based on the German Pharmacoepidemiological Research Database. 14th International Congress of the European Geriatric Medicine Society, October 10-12, 2018, Berlin, Germany (oral presentation). Eur Geriatr Med (2018) 9 (Suppl 1):S39. http://doi.org/10.1007/s41999-018-0097-4
  • Pisa FE, Reinold J, Kollhorst B, Haug U, Schink T. Comparative safety of individual antidepressants regarding traumatic brain injury in older adults. 14th International Congress of the European Geriatric Medicine Society, October 10-12, 2018, Berlin, Germany (poster presentation). Eur Geriatr Med (2018) 9 (Suppl 1):S49. http://doi.org/10.1007/s41999-018-0097-4
  • Pisa F, Kollhorst B, Reinold J, Schink T, Haug U. Antidepressant use in the elderly and users' risk profiles: Baseline characteristics of a German claims-based cohort. 13th European Union Geriatric Medicine Society (EUGMS) Congress, September 20-22, 2017, Nice, France.
  • Reinold J, Kollhorst B, Schink T, Haug U, Pisa F. Antipsychotics use in the elderly and users' risk profiles: Baseline characteristics of a German claims-based cohort. 13th European Union Geriatric Medicine Society Congress (EUGMS), September 20-22, 2017, Nice, France.