Change in 1-year hospitalization of overall and older patients with major depressive disorder after second-generation antipsychotics augmentation treatment

• Published in: Journal of affective disorders Vol. 230; pp. 118 - 124
• Main Authors: Lin, Chun-Yuan, Lai, Te-Jen, Wu, Yu-Hsin, Chen, Ping-Kun, Lin, Yuan-Fu, Chien, I.-Chia
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.04.2018
• Subjects: Aged; Antipsychotic Agents - therapeutic use; Databases, Factual; Depression; Depressive Disorder, Major - drug therapy; Female; Geriatric/Aging/Elderly; Hospitalization - trends; Hospitals, Psychiatric - statistics & numerical data; Humans; Insurance, Health - statistics & numerical data; Male; Middle Aged; Pharmacoepidemiology; Pharmacotherapy; Taiwan; Treatment Outcome; Treatment resistance; Pharmacoepidemiology; Pharmacotherapy; Depression; Geriatric/Aging/Elderly; Treatment resistance
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2018.01.011

Studies on second-generation antipsychotics (SGA) augmentation treatment for older adults with major depressive disorder (MDD) remain limited. We aimed to investigate the effectiveness of SGA augmentation for overall and older patients with MDD inpatient history by assessing the change in 1-year hospitalization before and after SGA augmentation using the latest National Health Insurance Research Database (NHIRD) in Taiwan. The samples were MDD patients (ICD-9 CM code: 296.2 and 296.3) who had psychiatric inpatient history. A total of 2602 MDD patients including 430 elderly subjects (age ≥ 60 years) who received SGA augmentation for 8 weeks between January 1998 and December 2012 were included in this 1-year mirror-image study. Outcome measures included number and length of psychiatric and all-cause hospitalizations. After 8-week continuous SGA augmentation in the study subjects, the total number and days of psychiatric hospitalizations among overall patients reduced by 33.57% (p < .0001) and 18.24% (p < .0001), respectively; the total number and days of psychiatric hospitalizations among older patients (age ≥ 60) reduced by 44.52% (p < .0001) and 27.95% (p < .0001), respectively. Similarly, the total number and days of all-cause hospitalizations were significantly reduced. MDD patients without inpatient history were not included due to data limitation; hence, the results may not be generalized to all patients. The results support that SGA may be effective in reducing psychiatric and all-cause hospitalization among overall and elderly MDD patients. More studies focusing on the safety of SGA among older MDD patients is warranted. •Characteristics of older adults with MDD inpatient history are reported.•The study reveals the impact of SGA on hospitalization of older MDD patients.•SGA may be effective in reducing hospitalization among MDD patients.•Clinicians should interpret the results cautiously for several limitations.