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Antidepressants and the risk of traumatic brain injury in the elderly: Differences between individual agents

Clinical Epidemiology Feb 24, 2019

Pisa FE, et al. - Researchers investigated how individual antidepressants (ADs) are associated with the risk of traumatic brain injury (TBI) in the elderly via conducting a case–control study nested in a cohort of new users of ADs aged ≥65 years, identified in the German Pharmacoepidemiological Research Database during 2005–2014. Among 701,309 cohort members, they identified 16,750 cases and matched these to 1,673,320 controls (in both groups: 70.4% women; median age 80 years). Adjusted OR (aOR) observed in current users was 1.87 for duloxetine, 1.74 for escitalopram, 1.70 for citalopram, 1.66 for sertraline, 1.64 for fluoxetine and 1.57 for paroxetine when compared with remote users of the same AD. The lower aOR was noted for amitriptyline (1.45), trimipramine (1.17) and opipramol (1.11). aOR for mirtazapine was 1.03. This suggests the existence of a large variability between individual ADs which highlights the significance of considering the safety of individual agents rather than focusing on class alone.
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