Citation

Albrecht JS, Wickwire E, Mullins CD, Rao V. J. Neurotrauma 2019; ePub(ePub): ePub.

Affiliation

Johns Hopkins, 1466, Baltimore, Maryland, United States; vrao@jhmi.edu.

Copyright

(Copyright © 2019, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2019.6580

PMID

31775590

Abstract

The relationship between psychotropic medication use and traumatic brain injury (TBI) is not well understood. The objective of this study was to describe patterns of psychotropic medication use during the months before and after TBI and compare with a non-TBI cohort. We conducted a retrospective cohort study using administrative claims data for a commercially insured population from 2008-2014 and assessed monthly prevalence of psychotropic medication use by class before and after TBI (or matched index in the non-TBI controls). We tested time trends and quantified rates of increase using autoregressive models and determined whether TBI impacted psychotropic medication use using difference-in-difference models. Compared to those without TBI (n=414,708), individuals with TBI (n=207,354) were more likely to receive any psychotropic medication both before (36.9% vs 19.5%, p<0.001) and after TBI (48.2% vs. 25.7%, p<0.001). Prior to TBI, the rate of monthly increase in use of psychotropic medications in the TBI cohort was 3-4 times the rate observed in the non-TBI cohort and was highest for antidepressants in both cohorts. After accounting for between group differences and time trends, TBI was associated with increased use of psychotropic medications including antipsychotics (rate ratio (RR) 1.08; 95%CI 1.07,1.09) and anxiolytics (RR 1.05; 95%CI 1.04,1.06). Patterns of psychotropic medication use differed significantly between individuals with and without TBI. These results suggest that a better understanding of events leading up to and following TBI is needed to elucidate the role psychotropic medications play in the natural history of TBI.

Language: en

Keywords

EPIDEMIOLOGY; NEUROPSYCHOLOGY; TRAUMATIC BRAIN INJURY