Background: The choice of antidepressants for initial pharmacological treatment of depression in older adults and associated patients' characteristics are understudied. We aimed to describe the first selected antidepressant (first-choice) for depression in older adults (≥65 years) and whether patients' sociodemographic and clinical characteristics influence selecting an alternative first-choice (any other antidepressant than the nationally recommended first-choice sertraline) in Denmark.
Methods: Register-based cross-sectional study including all older adults who redeemed their first antidepressant prescription for depression at community pharmacies in Denmark in 2015-2019. We analyzed the effect of patients' characteristics on the first-choice antidepressant selection using multinomial logistic regression.
Results: Among 34,337 older adults with a first antidepressant-prescription, over two-thirds filled alternative first-choice antidepressants than sertraline (28.9 %): escitalopram or citalopram (30.3 %) or mirtazapine (34.4 %). Socially disadvantaged older adults (e.g., with short educational attainment, being single, or of non-western ethnicity) and clinically vulnerable older adults (e.g., having somatic diagnoses and hospital contacts) were more likely to use alternative first-choice antidepressants.
Limitations: Information on prescribers and in-hospital medications was not included in this study.
Conclusions: Further investigation of the first antidepressant selection and its impact on depression treatment outcomes in older adults is necessary. Moreover, for older patients, national guidelines on depression treatment should be more specific.
Article Summary: Antidepressant selection for initial pharmacological treatment of depression in older adults can be difficult due to comorbidity, polypharmacy, and age-related changes in pharmacokinetics and pharmacodynamics. Real-world evidence/knowledge on first-choice antidepressant selection and associated user characteristics are rare. This Danish register-based cross-sectional study found over two-thirds of older adults filled alternative antidepressants (primarily escitalopram/citalopram or mirtazapine) than nationally recommended first-choice sertraline for depression treatment and identified wide-ranging sociodemographic and clinical factors influencing the first antidepressant selection.
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http://dx.doi.org/10.1016/j.jad.2023.04.110 | DOI Listing |
J Speech Lang Hear Res
January 2025
Department of Linguistics and Modern Languages, The Chinese University of Hong Kong, China.
Purpose: This study aims to examine the associations of phonological, lexical, and grammatical skills within and between languages in Mandarin-English bilingual preschoolers.
Method: Sixty-three Singaporean Mandarin-English bilingual children aged 3-5 years were assessed for articulation, receptive vocabulary, and receptive grammar using standardized instruments in English and compatible tools in Mandarin. Regression analyses were performed on each language outcome, with other language variables as predictors, controlling for age, nonverbal working memory, and home language environment.
Cancer Epidemiol Biomarkers Prev
January 2025
A.C. Camargo Cancer Center, São Paulo, Brazil.
Background: Oropharyngeal cancer (OPC) incidence is rising globally, predominantly in high-income countries due to human papillomavirus (HPV) infection. However, further data on OPC incidence in Brazil is needed. The aim of this study was to estimate the incidence, trends, and predictions of OPC in Brazilian population-based cancer registries (PBCRs) by period, sex, and topography.
View Article and Find Full Text PDFAIDS Patient Care STDS
January 2025
Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, Oakland, California, USA.
Community health workers (CHWs) play a significant role in supporting health services delivery in communities with few trained health care providers. There has been limited research on ways to optimize the role of CHWs in HIV prevention service delivery. This study explored CHWs' experiences with offering HIV prevention services [HIV testing and HIV pre- and post-exposure prophylaxis (PrEP and PEP)] during three pilot studies in rural communities in Kenya and Uganda, which aimed to increase biomedical HIV prevention coverage via a structured patient-centered HIV prevention delivery model.
View Article and Find Full Text PDFJAMA Neurol
January 2025
Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia.
JAMA Netw Open
January 2025
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Importance: During buprenorphine treatment for opioid use disorder (OUD), risk factors for opioid relapse or treatment dropout include comorbid substance use disorder, anxiety, or residual opioid craving. There is a need for a well-powered trial to evaluate virtually delivered groups, including both mindfulness and evidence-based approaches, to address these comorbidities during buprenorphine treatment.
Objective: To compare the effects of the Mindful Recovery Opioid Use Disorder Care Continuum (M-ROCC) vs active control among adults receiving buprenorphine for OUD.
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