Risk of Dementia Among Elderly Nursing Home Patients Using Paroxetine and Other Selective Serotonin Reuptake Inhibitors

Vishal Bali; Satabdi Chatterjee; Ryan M Carnahan; Hua Chen; Michael L Johnson; Rajender R Aparasu

doi:10.1176/appi.ps.201500011

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Risk of Dementia Among Elderly Nursing Home Patients Using Paroxetine and Other Selective Serotonin Reuptake Inhibitors

Journal article

Open access

Peer reviewed

Risk of Dementia Among Elderly Nursing Home Patients Using Paroxetine and Other Selective Serotonin Reuptake Inhibitors

Vishal Bali, Satabdi Chatterjee, Ryan M Carnahan, Hua Chen, Michael L Johnson and Rajender R Aparasu

Psychiatric services (Washington, D.C.), Vol.66(12), pp.1333-1340

12/01/2015

DOI: 10.1176/appi.ps.201500011

PMID: 26234334

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Abstract

Selective serotonin reuptake inhibitors (SSRIs) are the first line of treatment for depression. Among the SSRIs, paroxetine has strong anticholinergic properties and may lead to increased risk of adverse cognitive outcomes among elderly patients. This study evaluated the comparative risk of dementia associated with use of paroxetine and other SSRIs among elderly nursing home patients. A retrospective cohort study using propensity score matching was conducted with 2007-2010 Minimum Data Set-linked Medicare data. The study population included elderly nursing home patients with depression who were new users of SSRIs. Patients were followed for a maximum of two years after index SSRI use. The risk of dementia was modeled by using a robust Cox proportional hazards model to account for clustering within matched users of paroxetine and other SSRIs. The unmatched cohort included 19,952 new users of SSRIs; 1,898 used paroxetine, and 18,054 used other SSRIs. In the propensity-matched cohort of 3,796 patients, the unadjusted incidence of dementia was 7.5% for users of paroxetine and 8.6% for users of other SSRIs. There was no difference in the risk of dementia for users of paroxetine or other SSRIs. These study findings remained robust in multiple sensitivity analyses involving various measures of dementia. Compared with use of other SSRIs, use of paroxetine was not associated with higher risk of dementia among elderly nursing home patients with depression. Future studies are needed to evaluate the impact of paroxetine on other cognition measures.

Nursing Homes

Comorbidity

United States - epidemiology

Humans

Proportional Hazards Models

Serotonin Uptake Inhibitors - therapeutic use

Serotonin Uptake Inhibitors - adverse effects

Depressive Disorder - drug therapy

Male

Risk

Homes for the Aged

Paroxetine - therapeutic use

Dementia - epidemiology

Paroxetine - adverse effects

Aged, 80 and over

Female

Aged

Retrospective Studies

Depressive Disorder - epidemiology

Causality

Cohort Studies

Details

Title: Subtitle: Risk of Dementia Among Elderly Nursing Home Patients Using Paroxetine and Other Selective Serotonin Reuptake Inhibitors
Creators: Vishal Bali - University of Houston
Satabdi Chatterjee - University of Houston
Ryan M Carnahan - University of Iowa, Epidemiology
Hua Chen - University of Houston
Michael L Johnson - University of Houston
Rajender R Aparasu - University of Houston
Resource Type: Journal article
Publication Details: Psychiatric services (Washington, D.C.), Vol.66(12), pp.1333-1340
DOI: 10.1176/appi.ps.201500011
PMID: 26234334
NLM abbreviation: Psychiatr Serv
ISSN: 1075-2730
eISSN: 1557-9700
Publisher: United States
Grant note: R01HS021264 / AHRQ HHS
Language: English
Date published: 12/01/2015
Academic Unit: Epidemiology; Injury Prevention Research Center
Record Identifier: 9983995120102771

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