Abstract
Objective
To explore the temporal dynamic of antidepressant and antipsychotic co‐prescribing in real‐life conditions.
Methods
The study was performed using reimbursement data from the French Insurance Healthcare system in a cohort of 118,454 persons with at least one dispensing of antidepressants and/or antipsychotics over the period 2006‐2016. Latent class analyses were used to identify homogeneous groups of persons following similar multi‐trajectories of antidepressant and/or antipsychotic dispensing. Multivariate polynomial logistic regression models were used to explore the characteristics independently associated with distinct trajectories.
Results
Five multi‐trajectories of antidepressant and/or antipsychotic dispensing were identified: more than half of the sample (58%) had very low antidepressant and antipsychotic use; two groups had chronic (12%) or decreasing (11%) antidepressant use with very low antipsychotic use; two groups used both antidepressants and antipsychotics simultaneously either in an increasing (12%) or chronic (7%) way. Persons with chronic antidepressant‐antipsychotic use presented with markers of poor social and mental health conditions.
Conclusions
Most persons using antipsychotics over the follow‐up also used antidepressants over the same period. The benefit/risk ratio of these prescribing practices should be further explored as the long‐term efficacy of antidepressant‐antipsychotic polypharmacy is poorly documented, while this combination increases the risk of adverse effects.
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