Claims data analysis on the dispensing of tricyclic antidepressants among patients with dementia in Germany

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Hessmann, P.; Zeidler, J.; Stahmeyer, J.; Eberhard, S.; Vogelgsang, J. et al.: Claims data analysis on the dispensing of tricyclic antidepressants among patients with dementia in Germany. In: Frontiers in Pharmacology 10 (2019), 841. DOI:

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Objective: A restrictive use of tricyclic antidepressants (TCA) in patients with dementia (PwD) is recommended due to the hazard of anticholinergic side effects. We evaluated the frequency of TCA dispensing in PwD over a period of 1 year and the use of TCA before and after the incident diagnosis of dementia. Methods: This analysis was based on administrative data from a German statutory health insurance for a period of 2 years. Totally, 20,357 patients with an incident diagnosis of dementia in 2014 were included. We evaluated the dispensing of TCA in 2015. Subgroup analyses were conducted to evaluate associations between the incident diagnosis of dementia and modifications in TCA dispensing. Results: In 2015, 1,125 dementia patients (5.5%) were treated with TCA and 31% were medicated with TCA in all four quarters of 2015. Most dispensings were conducted by general practitioners (67.9%). On average, patients received 3.7 ± 2.6 dispensings per year. Amitriptyline (56.3%), doxepin (26.8%), and trimipramine (16.8%) were dispensed most often. Subgroup analyses revealed that the dispensing of TCA remained mainly unchanged following the incident diagnosis. Conclusion: A relevant number of PwD were treated with TCA. To maintain the patients' safety, an improved implementation of guidelines for the pharmaceutical treatment of PwD in healthcare institutions might be required. Since 68% of the patients suffered from depression, future studies should further evaluate the indications for TCA. Copyright © 2019 Hessmann, Zeidler, Stahmeyer, Eberhard, Vogelgsang, Abdel-Hamid, Wolff-Menzler, Wiltfang and Kis. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
License of this version: CC BY 4.0 Unported
Document Type: Article
Publishing status: publishedVersion
Issue Date: 2019
Appears in Collections:Forschungszentren

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pos. country downloads
total perc.
1 image of flag of Germany Germany 57 62.64%
2 image of flag of United States United States 13 14.29%
3 image of flag of China China 4 4.40%
4 image of flag of No geo information available No geo information available 2 2.20%
5 image of flag of France France 2 2.20%
6 image of flag of Iran, Islamic Republic of Iran, Islamic Republic of 1 1.10%
7 image of flag of India India 1 1.10%
8 image of flag of Israel Israel 1 1.10%
9 image of flag of Greece Greece 1 1.10%
10 image of flag of United Kingdom United Kingdom 1 1.10%
    other countries 8 8.79%

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