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Drug Use before and after Initiating Treatment with Acetylcholinesterase Inhibitors

机译:乙酰胆碱酯酶抑制剂开始治疗前后的药物使用

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Background/Aims: The aim was to study the prevalence of use of different drugs prescribed for behavioral and psychological symptoms of dementia in persistent users of acetylcholinesterase inhibitors (AChEIs) before and after AChEI initiation, and to compare with the use in the general population. Methods: Use of antidepressants, antipsychotics, and analgesics in the 4 years before and 2 years after AChEI initiation was studied based on data from the Norwegian Prescription Database 2004–2016. Results: The prevalence of use of antidepressants and antipsychotics the year before AChEI initiation was twice the prevalence in the age-adjusted general population and continued to rise in the first 2 years after initiation of AChEIs. The prevalence of weak analgesics and antipsychotics increased strongly in the last year before AChEI initiation. The increase in the use of antidepressants started at least 4 years before initiation of AChEIs. Opioid use was generally lower than in the general population and was not influenced by AChEI initiation. Conclusion: Increased use of antidepressants and antipsychotics was observed both before and after initiation of AChEIs and may indicate that behavioral symptoms occur in a preclinical or early phase of Alzheimer’s disease. The prescription pattern of analgesics with a low use of opioids may indicate an undertreatment of pain in people with dementia.
机译:背景/目的:目的是研究在乙酰胆碱酯酶抑制剂(AChEI)持续使用之前和之后,长期使用乙酰胆碱酯酶抑制剂(AChEIs)的痴呆患者行为和心理症状的不同药物的使用率,并与普通人群进行比较。方法:根据2004-2016年挪威处方数据库中的数据,研究了AChEI起始前4年和起始2年后抗抑郁药,抗精神病药和镇痛药的使用情况。结果:在开始使用AChEI的前一年,使用抗抑郁药和抗精神病药的患病率是经过年龄调整的普通人群的两倍,并且在开始使用AChEI的前2年中持续上升。在开始使用AChEI之前的最后一年,弱势镇痛药和抗精神病药的患病率急剧上升。在开始使用AChEI之前至少4年开始使用抗抑郁药。阿片类药物的使用通常低于一般人群,并且不受AChEI起始的影响。结论:在开始AChEIs之前和之后,抗抑郁药和抗精神病药的使用均增加,这可能表明行为症状出现在阿尔茨海默氏病的临床前或早期阶段。阿片类药物使用量较少的止痛药的处方模式可能表明痴呆症患者的疼痛治疗不足。

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