Affiliation:
1. University Health Care Research Centre, Faculty of Medicine and Health Örebro University Örebro Sweden
2. Institute of Neuroscience and Physiology the Sahlgrenska Academy at Gothenburg University Gothenburg Sweden
3. Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
Abstract
AbstractObjectiveThis study aimed to associate antidepressants with versus without antipsychotics with readmission and suicide in patients with psychotic unipolar depression.MethodsSwedish national registers were used to identify inpatients with psychotic unipolar depression, treated 2007–2016. The participants collected antidepressants with or without antipsychotics from a pharmacy within 14 days after discharge and were followed up for 2 years. The primary outcome was hospital readmission due to any psychiatric disorder, suicide attempt, or completed suicide. Cox regression was used to analyze the data, which were adjusted for sex, age, prior admissions, comorbidity, electroconvulsive therapy, and other pharmacological treatments.ResultsWe identified 4391 patients, of which 2972 were in the antidepressant + antipsychotic combination therapy group, and 1419 were in the antidepressant monotherapy group. After 2 years, 42.3% and 36.6% of patients were readmitted or committed suicide in the combination therapy and monotherapy group, respectively. Monotherapy was significantly associated with a lower risk of reaching the outcome in the main analysis (hazard ratio = 0.86; 95% confidence interval: 0.77–0.95). The results went in the same direction in all sensitivity analyses.ConclusionOur findings do not indicate any advantage of adding antipsychotics as adjunctive to antidepressants as maintenance treatment. Considering the wide use, known side effects, and the current lack of evidence supporting the benefit, further studies on the effect of antipsychotics in the maintenance phase of psychotic unipolar depression are urgently warranted.
Subject
Psychiatry and Mental health
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献