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Lifestyle factors, psychiatric and neurologic comorbidities, and drug use associated with incident seizures among adult patients with depression: a population-based nested case–control study

  • PSYCHIATRIC EPIDEMIOLOGY
  • Published:
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Abstract

To investigate risk factors for incident seizures among adult patients with depression. We conducted a nested case–control analysis in adult patients with newly diagnosed depression, using data from the U.K.-based Clinical Practice Research Datalink. Among cases with incident seizures and matched controls, we estimated odds ratios (ORs) with 95 % confidence intervals (CIs) of potential risk factors for seizures as reported from data of the general population: underweight (body mass index <18.5 kg/m2), smoking, alcoholism, drug abuse, psychiatric or neurologic comorbidities, and concomitant use of drugs. Of 186,540 patients with depression, 1489 developed a seizure during follow-up. Being underweight (OR 1.67 [95 % CI 1.23–2.26]), a current smoker (OR 1.45 [95 % CI 1.26–1.67]), having alcoholism (OR 2.98 [95 % CI 2.56–3.47]), and drug abuse (OR 2.51 [95 % CI 1.94–3.24]), were associated with increased risks of seizures compared to normal weight, non-smoking, no alcoholism, and no drug abuse, respectively. Previous stroke/transient ischemic attack (OR 6.07 [95 % CI 4.71–7.83]) or intracerebral bleeding (OR 8.19 [95 % CI 4.80–13.96]), and comorbid dementia (OR 6.83 [95 % CI 4.81–9.69]), were strongly associated with seizures. Current use of cephalosporins (OR 2.47 [95 % CI 1.61–3.78]) and antiarrhythmics (OR 1.59 [95 % CI 1.26–2.01]) was associated with an increased risk of seizures compared to non-use. Among adult patients with depression, being underweight, smoking, alcoholism, and drug abuse, were associated with seizures. Remote stroke and comorbid dementia were strong risk factors for seizures. Current use of cephalosporins or antiarrhytmics was associated with an increased risk of seizures compared to non-use.

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Acknowledgments

We thank Pascal Egger for the programming and technical support.

Author contributions

Study conception and design: MBl, AC, SR, SJ, CM, MBo. Acquisition of data, guarantors for the study: SJ, CM. Analysis and interpretation of data: MBl, CM, MBo. Drafting the manuscript: MBl. Editing the manuscript: AC, SR, SJ, CM, MBo.

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Authors and Affiliations

  1. Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland

    Marlene Bloechliger, Christoph Rudolf Meier & Michael Bodmer

  2. National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland

    Alessandro Ceschi

  3. Division of Clinical Pharmacology and Toxicology, Department of Internal Medicine, Ente Ospedaliero Cantonale, Lugano, Switzerland

    Alessandro Ceschi

  4. Division of Clinical Neurophysiology, Department of Neurology, University Hospital Basel, Basel, Switzerland

    Stephan Rüegg

  5. Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA, USA

    Susan Sara Jick & Christoph Rudolf Meier

  6. Hospital Pharmacy, University Hospital Basel, Spitalstrasse 26, 4031, Basel, Switzerland

    Christoph Rudolf Meier

  7. Medical Department, Zuger Kantonsspital, Zug, Switzerland

    Michael Bodmer

Authors
  1. Marlene Bloechliger
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  2. Alessandro Ceschi
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  3. Stephan Rüegg
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  4. Susan Sara Jick
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  5. Christoph Rudolf Meier
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  6. Michael Bodmer
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Correspondence to Christoph Rudolf Meier.

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Bloechliger, M., Ceschi, A., Rüegg, S. et al. Lifestyle factors, psychiatric and neurologic comorbidities, and drug use associated with incident seizures among adult patients with depression: a population-based nested case–control study. Eur J Epidemiol 31, 1113–1122 (2016). https://doi.org/10.1007/s10654-016-0156-4

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  • DOI: https://doi.org/10.1007/s10654-016-0156-4

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