Abstract
Objectives
Antiepileptic drugs (AEDs) are frequently prescribed for persons with Alzheimer’s
disease (AD), but little is known on factors associated with AED initiation in this
population. We investigated whether recent hospitalization is associated with AED
initiation in persons with AD.
Design
Nested case-control study in the nationwide register-based Medication use and Alzheimer’s
disease (MEDALZ) cohort.
Participants and Settings
The MEDALZ cohort includes 70,718 persons diagnosed with AD during 2005-2011 in Finland.
Altogether 6814 AED initiators and 6814 age-, sex-, and time since AD diagnosis-matched
noninitiators were included in this study. Matching date was the date of AED initiation.
Methods
AED purchases were identified from the Prescription Register and hospitalizations
from the Care Register for Health Care. Recent hospitalization was defined as hospitalization
ending within 2 weeks before the matching date. Association between recent hospitalization
and AED initiation was assessed with conditional logistic regression.
Results
The most frequently initiated AEDs were pregabalin (42.9%) and valproic acid (32.2%).
A bigger proportion of AED initiators (36.9%) than noninitiators (5.3%) were recently
hospitalized [odds ratio (OR) 10.5, 95% CI 9.22-11.9]. Dementia was the most frequent
discharge diagnosis among AED initiators (29.1%) and noninitiators (27.9%). Among
AED initiators, the next most frequent diagnosis was epilepsy (20.6%). Musculoskeletal
diagnoses and use of analgesics including opioids was more common among gabapentinoid
initiators compared with other AED initiators.
Conclusions and Implications
Recent hospitalization was significantly related to AED initiation. Initiations of
AED might have been related to common symptoms in persons with AD like neuropathic
pain, epilepsy, and neuropsychiatric symptoms.
Keywords
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Article info
Publication history
Published online: November 17, 2022
Publication stage
In Press Corrected ProofFootnotes
Declarations: S.H. reports lecture fees from Eisai. A.M.T. acknowledges a research grant from Amgen, paid to the institution where she is employed (outside of the submitted work). J.E., M.K., and M.T. declare no conflicts of interest.
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© 2022 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
