Psychotropic and anti-epileptic drug use, before and after surgery, among patients with low-grade glioma: a nationwide matched cohort study

Isabelle Rydén,Øyvind Salvesen,Erik Thurin,Louise Carstam,Sasha Gulati,Roger Henriksson,Anja Smits,Asgeir Store Jakola

doi:10.1186/s12885-021-07939-w

Abstract

BackgroundLow-grade glioma (LGG) is a relatively rare type of brain tumour. The use of antidepressant, sedative and anti-epileptic drugs can reflect the burden of the disease. While epilepsy is well-described in patients with LGG, less is known about depression and anxiety.MethodsWe used nationwide registers to study the use (dispense) of antidepressants, sedatives, and anti-epileptic drugs (AEDs) before and after histopathological LGG diagnosis (WHO grade II). A total of 485 adult patients with a first-time diagnosis and a matched control cohort (n = 2412) were included. Patterns of use were analysed from one year prior to until one year following index date (date of surgery). Logistic regression analysis identified predictors for postoperative use.ResultsAt one year before index date, patients were dispensed AEDs 4 times more than controls, while antidepressants and sedatives were similar. Sedatives and AED peaked shortly after index date at 25 and 69%, respectively. AEDs then stabilized while sedatives decreased rapidly. For antidepressants, a delayed increase was seen after index date, stabilizing at 12%. At one year after index date, the use of antidepressants, sedatives, and AEDs among patients was 2, 3, and 26 times higher, respectively, compared to controls. Predictor for use of AEDs and sedatives at one year following index was previous use and/or a related diagnosis. Female sex and later index year were additional predictors for antidepressants.ConclusionsUse of antidepressants, sedatives and AEDs is elevated following diagnosis of LGG. Antidepressants were more commonly dispensed to female patients and in recent years.

Highlights

Low-grade glioma (LGG) is a relatively rare type of brain tumour
LGG was defined as grade II astrocytoma, oligoastrocytoma or oligodendroglioma according to the 2007 WHO classification of brain tumours [21]
We found that the use of antidepressants, sedatives and Antiepileptic drugs (AED) in patients with LGG was elevated at 1 year following surgery, compared to matched controls

Summary

Introduction

Low-grade glioma (LGG) is a relatively rare type of brain tumour. The use of antidepressant, sedative and anti-epileptic drugs can reflect the burden of the disease. Much of the data on depression and anxiety in patients with LGG come from studies including patients with brain tumours of different types and grades, applying various methodologies, making it difficult to draw conclusions for the group of LGG in specific [16,17,18,19,20]. An intriguing way to obtain further data is to study dispense of sedatives (anxiolytics, hypnotics and sedatives) and antidepressants, which reflects the use of these drugs in the LGG population and can serve as indicators of depression and anxiety disorders. By this approach we may be able to address potential discrepancies between expected symptom burden and treatment provided [17]

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