Change in Antidepressant Use After Initiation of ADHD Medication in Japanese Adults with Comorbid Depression: A Real-World Database Analysis

Chika Sakai,1 Toshinaga Tsuji,1 Toru Nakai,1 Yuki Namba,1 Hirokazu Mishima,1 Masakazu Fujiwara,2 Hisato Matsunaga3 1Medical Affairs Department, Shionogi & Co. Ltd, Osaka, Japan; 2Data Science Office, Shionogi & Co. Ltd, Osaka, Japan; 3Department of Neuropsychiatry, Hyogo College of Medicine,...

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Autores principales: Sakai C, Tsuji T, Nakai T, Namba Y, Mishima H, Fujiwara M, Matsunaga H
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Lenguaje:EN
Publicado: Dove Medical Press 2021
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spelling oai:doaj.org-article:edc24c732b164b5b97463b4ecb0e2c742021-12-02T16:58:33ZChange in Antidepressant Use After Initiation of ADHD Medication in Japanese Adults with Comorbid Depression: A Real-World Database Analysis1178-2021https://doaj.org/article/edc24c732b164b5b97463b4ecb0e2c742021-10-01T00:00:00Zhttps://www.dovepress.com/change-in-antidepressant-use-after-initiation-of-adhd-medication-in-ja-peer-reviewed-fulltext-article-NDThttps://doaj.org/toc/1178-2021Chika Sakai,1 Toshinaga Tsuji,1 Toru Nakai,1 Yuki Namba,1 Hirokazu Mishima,1 Masakazu Fujiwara,2 Hisato Matsunaga3 1Medical Affairs Department, Shionogi & Co. Ltd, Osaka, Japan; 2Data Science Office, Shionogi & Co. Ltd, Osaka, Japan; 3Department of Neuropsychiatry, Hyogo College of Medicine, Hyogo, JapanCorrespondence: Toshinaga TsujiMedical Affairs Department, Shionogi & Co. Ltd, 3-1-8, Doshomachi, Chuo-ku, Osaka-shi, Osaka, 541-0045, JapanTel +81 6 6209 7412Fax +81 6 6202 2239Email toshinaga.tsuji@shionogi.co.jpPurpose: To better understand the treatment of comorbid depression in adults with attention-deficit/hyperactivity disorder (ADHD) by investigating the prescription patterns of antidepressants, anxiolytics, and hypnotics after commencing ADHD medication.Patients and Methods: In this retrospective observational study in Japan, the data of patients initiating ADHD medication while already receiving antidepressants (ADHD group) and of patients prescribed antidepressants but not diagnosed with ADHD (control group) were extracted from an electronic medical record database. Additionally, one-to-one matching for patients in both groups was performed using sex, age, baseline dosage of antidepressants, and any comorbid psychiatric disorders as covariates. The observation period included a 1-month baseline period and a 6-month follow-up period. The percentage of patients prescribed antidepressants and the mean prescribed dosages were compared between matched-cohort groups. Prescriptions for anxiolytics and hypnotics were also assessed.Results: In the matched cohorts, consisting of 239 patients in the ADHD group and 239 patients from the unmatched control cohort of 10,485, the percentage of patients prescribed antidepressants decreased from baseline in both groups to 94.1% in the ADHD group and 89.5% in the control group during the first month of follow-up, and 77.0% and 78.7%, respectively, during the last month. There were no significant differences between groups in the percentages of patients prescribed antidepressants or in the mean prescribed dosages of antidepressants at any time point over the follow-up period. Prescribed dosages of anxiolytics and hypnotics tended to be lower in the ADHD group.Conclusion: The two groups were medicated similarly with respect to their depressive symptoms over 6 months. Our results suggest that in patients with ADHD and comorbid depression, which is more likely to be more severe than in depression without ADHD, depressive symptoms are managed following initiation of add-on ADHD medication, without requiring higher antidepressant dosages than in patients with depression only.Keywords: attention-deficit/hyperactivity disorder, MDD, antidepressants, anxiolytics, hypnoticsSakai CTsuji TNakai TNamba YMishima HFujiwara MMatsunaga HDove Medical Pressarticleattention-deficit/hyperactivity disordermddantidepressantsanxiolyticshypnoticsNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 17, Pp 3097-3108 (2021)
institution DOAJ
collection DOAJ
language EN
topic attention-deficit/hyperactivity disorder
mdd
antidepressants
anxiolytics
hypnotics
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
spellingShingle attention-deficit/hyperactivity disorder
mdd
antidepressants
anxiolytics
hypnotics
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Sakai C
Tsuji T
Nakai T
Namba Y
Mishima H
Fujiwara M
Matsunaga H
Change in Antidepressant Use After Initiation of ADHD Medication in Japanese Adults with Comorbid Depression: A Real-World Database Analysis
description Chika Sakai,1 Toshinaga Tsuji,1 Toru Nakai,1 Yuki Namba,1 Hirokazu Mishima,1 Masakazu Fujiwara,2 Hisato Matsunaga3 1Medical Affairs Department, Shionogi & Co. Ltd, Osaka, Japan; 2Data Science Office, Shionogi & Co. Ltd, Osaka, Japan; 3Department of Neuropsychiatry, Hyogo College of Medicine, Hyogo, JapanCorrespondence: Toshinaga TsujiMedical Affairs Department, Shionogi & Co. Ltd, 3-1-8, Doshomachi, Chuo-ku, Osaka-shi, Osaka, 541-0045, JapanTel +81 6 6209 7412Fax +81 6 6202 2239Email toshinaga.tsuji@shionogi.co.jpPurpose: To better understand the treatment of comorbid depression in adults with attention-deficit/hyperactivity disorder (ADHD) by investigating the prescription patterns of antidepressants, anxiolytics, and hypnotics after commencing ADHD medication.Patients and Methods: In this retrospective observational study in Japan, the data of patients initiating ADHD medication while already receiving antidepressants (ADHD group) and of patients prescribed antidepressants but not diagnosed with ADHD (control group) were extracted from an electronic medical record database. Additionally, one-to-one matching for patients in both groups was performed using sex, age, baseline dosage of antidepressants, and any comorbid psychiatric disorders as covariates. The observation period included a 1-month baseline period and a 6-month follow-up period. The percentage of patients prescribed antidepressants and the mean prescribed dosages were compared between matched-cohort groups. Prescriptions for anxiolytics and hypnotics were also assessed.Results: In the matched cohorts, consisting of 239 patients in the ADHD group and 239 patients from the unmatched control cohort of 10,485, the percentage of patients prescribed antidepressants decreased from baseline in both groups to 94.1% in the ADHD group and 89.5% in the control group during the first month of follow-up, and 77.0% and 78.7%, respectively, during the last month. There were no significant differences between groups in the percentages of patients prescribed antidepressants or in the mean prescribed dosages of antidepressants at any time point over the follow-up period. Prescribed dosages of anxiolytics and hypnotics tended to be lower in the ADHD group.Conclusion: The two groups were medicated similarly with respect to their depressive symptoms over 6 months. Our results suggest that in patients with ADHD and comorbid depression, which is more likely to be more severe than in depression without ADHD, depressive symptoms are managed following initiation of add-on ADHD medication, without requiring higher antidepressant dosages than in patients with depression only.Keywords: attention-deficit/hyperactivity disorder, MDD, antidepressants, anxiolytics, hypnotics
format article
author Sakai C
Tsuji T
Nakai T
Namba Y
Mishima H
Fujiwara M
Matsunaga H
author_facet Sakai C
Tsuji T
Nakai T
Namba Y
Mishima H
Fujiwara M
Matsunaga H
author_sort Sakai C
title Change in Antidepressant Use After Initiation of ADHD Medication in Japanese Adults with Comorbid Depression: A Real-World Database Analysis
title_short Change in Antidepressant Use After Initiation of ADHD Medication in Japanese Adults with Comorbid Depression: A Real-World Database Analysis
title_full Change in Antidepressant Use After Initiation of ADHD Medication in Japanese Adults with Comorbid Depression: A Real-World Database Analysis
title_fullStr Change in Antidepressant Use After Initiation of ADHD Medication in Japanese Adults with Comorbid Depression: A Real-World Database Analysis
title_full_unstemmed Change in Antidepressant Use After Initiation of ADHD Medication in Japanese Adults with Comorbid Depression: A Real-World Database Analysis
title_sort change in antidepressant use after initiation of adhd medication in japanese adults with comorbid depression: a real-world database analysis
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/edc24c732b164b5b97463b4ecb0e2c74
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