Association Between Prescription of Antidepressants and Delirium in the Elderly : Analysis From the World Health Organization Global Database

Study Overview
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Brief Summary
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Delirium is a frequent reason for hospitalisation of the elderly. Associations between the prescription of some medicines and the risk of delirium have already been demonstrated. Antidepressants are widely prescribed in the elderly because of the frequency of anxiety-depressive symptoms in this population, where there are high pharmacokinetic and pharmacodynamic variability. However, the association between antidepressants and the risk of delirium remains poorly understood. Based on the analysis from the World Health Organization global database, the main objective of this study is to investigate the association between the different classes of antidepressants and the occurrence of the  delirium  event reported in the database. A disproportionality analysis will be performed. It will aim to assess whether some classes of antidepressants, and within these classes some molecules, are associated with a greater risk of delirium.

Official Title
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Association Between Prescription of Antidepressants and Delirium in the Elderly : Analysis From the World Health Organization Global Database

Conditions
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Antidepressive Agents, Aged, Delirium

Intervention / Treatment
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* Drug: Antidepressant


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: be over 65 years old taking antidepressants to have presented delirium Exclusion Criteria: -

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 120 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Drug: Antidepressant|Delirium event reported in the World Health Organization global database in subjects aged over 65 years taking antidepressants, comparative analysis by antidepressant class|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Descriptive analysis of the studied population | From the WORLD HEALTH ORGANIZATION Vigibase pharmacovigilance database, the investigators select all patients over 65 years old. Then among them, the investigators report : Antidepressants use by class (Non-selective monoamine reuptake inhibitors, Selective serotonin reuptake inhibitors, Selective serotonin-norepinephrine reuptake Inhibitors, Alpha-2-adrenergic receptor antagonists, Monoamine oxidase inhibitors, other antidepressants) Delirium event Co-prescription (Opioids, Antipsychotics, Anxiolytics, Hynotics) Comorbidities (Constipation, acute retention of urine, hyponatraemia etc...) | 03/01/2022 | 
| Analysis of the association between antidepressant classes and delirium reporting, among subjects aged 65 or older | A disproportionality analysis is carried out in multivariate analysis, taking into account a certain number of confounding factors (co-prescriptions and comorbidities) | 03/01/2022 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Analysis by age group | Investigators study the association between antidepressant classes and delirium reporting for the age group 65-74 and for the age group 75 and over. A disproportionality analysis is carried out in multivariate analysis, taking into account a certain number of confounding factors (co-prescriptions and comorbidities) | 03/01/2022 | 
| Analysis of the co-reporting of delirium and hyponatraemia | Investigators study the association between antidepressant classes and co-reporting of delirium and hyponatraemia among subjects aged 65 or older. A disproportionality analysis is carried out in multivariate analysis, taking into account a certain number of confounding factors (co-prescriptions and comorbidities). | 03/01/2022 | 
| Analysis of the most prescribed antidepressant | Investigators study the association between most prescribed antidepressants and delirium reporting among patients aged 65 or older. We identified most prescribed antidepressants as those with more than 1000 cases reported in VigiBase®. A disproportionality analysis is carried out in multivariate analysis, taking into account a certain number of confounding factors (co-prescriptions and comorbidities). | 03/01/2022 |