Antiepileptic and psychiatric medication in a nationwide cohort of patients with glioma WHO grade II–IV

• Published in: Journal of neuro-oncology Vol. 140; no. 3; pp. 739 - 748
• Main Authors: Knudsen-Baas, Kristin Marie, Johannesen, Tom Børge, Myklebust, Tor Åge, Aarseth, Jan Harald, Owe, Jone Furlund, Gilhus, Nils Erik, Storstein, Anette Margrethe
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2018; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Anticonvulsants - adverse effects; Antidepressants; Antidepressive Agents - adverse effects; Anxiety; Anxiety - chemically induced; Brain cancer; Brain Neoplasms - complications; Brain Neoplasms - drug therapy; Brain Neoplasms - psychology; Brain tumors; Clinical Study; Cohort Studies; Confidence intervals; Depression - chemically induced; Epilepsy; Etiracetam; Female; Glioma; Glioma - complications; Glioma - drug therapy; Glioma - psychology; Humans; Levetiracetam - adverse effects; Male; Medicine; Medicine & Public Health; Mental depression; Middle Aged; Neurology; Oncology; Registries; Risk Factors; Treatment Outcome; Young Adult; Depression; Anxiety; Glioma; Antiepileptic drugs; Epilepsy
• ISSN: 0167-594X; 1573-7373
• DOI: 10.1007/s11060-018-03007-9

Introduction Glioma is the most common intracranial primary brain tumor. Patients with glioma often suffer from epilepsy, anxiety and depression. Aims of this study were to identify risk factors for drug-treated anxiety and depression, and to determine the use of psychiatric medication in a national glioma cohort. Methods Data from the Cancer Registry of Norway on all persons diagnosed with glioma WHO grade II–IV 2004–2010 were linked with data from the Norwegian Prescription Database. Cox regression analysis was used to assess risk factors for drug-treated anxiety and depression. Standardized incidence ratios were calculated for psychiatric medication dispensed to glioma patients and compared to the general population. Results The glioma cohort consisted of 1056 males and 772 females. Of the 1828 patients, 565 had glioma grade II–III, and 1263 had grade IV. The patients with glioma grade II–III who were treated with levetiracetam had an increased risk for drug-treated anxiety compared to patients without levetiracetam; hazard ratio 2.8 (95% confidence interval 1.7–4.9). Female gender increased the risk for drug-treated anxiety compared to males in patients with glioma grade IV; hazard ratio 1.5 (95% confidence interval 1.2–2.0). Antidepressants were less frequently dispensed to patients with glioma grade II–III and epilepsy than to the general population. Conclusions Patients with glioma grade II–III on levetiracetam had an increased risk for drug-treated anxiety. The subgroup of patients with glioma grade II–III and epilepsy received less antidepressants than the general population.