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dc.date.accessioned2020-11-20T12:10:35Z
dc.date.available2020-11-20T12:10:35Z
dc.date.created2020-08-06T20:36:41Z
dc.date.issued2020
dc.identifier.citationTveit, Kristine Hermann, Monica Waade, Ragnhild Birkeland Nilsen, Roy Miodini Wallerstedt, Susanna M. Molden, Espen . Use of Antidepressants in Older People during a 10-Year Period: An Observational Study on Prescribed Doses and Serum Levels. Drugs & Aging. 2020
dc.identifier.urihttp://hdl.handle.net/10852/81114
dc.description.abstractBackground According to previous studies, older patients frequently have serum concentrations of antidepressant medication above the recommended reference range. Objective The aim of this study was to investigate whether prescribed doses of antidepressants and the proportion of individuals with serum concentrations above the recommended reference range in older individuals (≥ 65 years) have changed over a 10-year period in Norway. Methods Serum concentration measurements and prescribed daily doses of antidepressants in 2007 and 2017 were extracted from a therapeutic drug monitoring (TDM) database at the Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway. The database contains routine follow-up serum concentration measurements of psychotropic drugs for patients from all parts of the country. For citalopram, escitalopram, sertraline, mirtazapine and venlafaxine, the differences between 2007 and 2017 in mean prescribed doses and the proportion of patients with at least one serum concentration above the reference range, according to the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) guidelines, were compared. For the proportion of patients with serum concentrations above the recommended reference range, differences between individuals aged 65–79 and ≥ 80 years were also examined. Results The analyses of prescribed doses included 806 patients from 2007 and 1932 patients from 2017, with 972 and 2441 TDM samples, respectively. Between 2007 and 2017, modest reductions in prescribed daily doses were observed for citalopram (20 vs. 17 mg/day) and escitalopram (11 vs. 10 mg/day), but the proportion of patients with serum concentrations above the recommended reference range was unchanged for both drugs, i.e. 11.5% vs. 12.4% for citalopram and 3.6% vs. 2.9% for escitalopram. For mirtazapine and venlafaxine, prescribed doses were reduced from 28 to 25 mg/day and 150 to 125 mg/day, respectively. A significant reduction in the proportion of individuals with serum concentrations above the recommended reference range was observed for mirtazapine (27.1% vs. 11.5%) and for individuals aged ≥ 80 years using venlafaxine (60.0% vs. 30.0%). For sertraline, no differences in prescribed doses or serum concentrations above the recommended reference range were observed. Conclusions Over a 10-year period, prescribed doses of antidepressants have been slightly reduced in older Norwegian patients, but a considerable proportion is still exposed to high serum concentrations of antidepressants.
dc.languageEN
dc.rightsAttribution-NonCommercial 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.titleUse of Antidepressants in Older People during a 10-Year Period: An Observational Study on Prescribed Doses and Serum Levels
dc.typeJournal article
dc.creator.authorTveit, Kristine
dc.creator.authorHermann, Monica
dc.creator.authorWaade, Ragnhild Birkeland
dc.creator.authorNilsen, Roy Miodini
dc.creator.authorWallerstedt, Susanna M.
dc.creator.authorMolden, Espen
cristin.unitcode185,0,0,0
cristin.unitnameUniversitetet i Oslo
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1
dc.identifier.cristin1822114
dc.identifier.bibliographiccitationinfo:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Drugs & Aging&rft.volume=&rft.spage=&rft.date=2020
dc.identifier.jtitleDrugs & Aging
dc.identifier.volume37
dc.identifier.issue9
dc.identifier.startpage691
dc.identifier.endpage701
dc.identifier.pagecount0
dc.identifier.doihttps://doi.org/10.1007/s40266-020-00784-9
dc.identifier.urnURN:NBN:no-84202
dc.type.documentTidsskriftartikkel
dc.type.peerreviewedPeer reviewed
dc.source.issn1170-229X
dc.identifier.fulltextFulltext https://www.duo.uio.no/bitstream/handle/10852/81114/2/Tveit.pdf
dc.type.versionPublishedVersion


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