Psychotropic medication use and Parkinson's disease risk amongst older women
Open accessAbstract
OBJECTIVE: To examine associations of antidepressant, anxiolytic and hypnotic use amongst older women (≥65 years) with incident Parkinson's Disease (PD), using data from Women's Health Initiative linked to Medicare claims. METHODS: PD was defined using self-report, first diagnosis, medications and/or death certificates and psychotropic medications were ascertained at baseline and 3-year follow-up. Cox regression models were constructed to calculate adjusted hazard ratios (aHR) with 95% confidence intervals (CI), controlling for socio-demographic, lifestyle and health characteristics, overall and amongst women diagnosed with depression, anxiety and/or sleep disorders (DASD). RESULTS: A total of 53,996 WHI participants (1,756 PD cases)-including 27,631 women diagnosed with DASD (1,137 PD cases)-were followed up for ~14 years. Use of hypnotics was not significantly associated with PD risk (aHR = 0.98, 95% CI: 0.82, 1.16), whereas PD risk was increased amongst users of antidepressants (aHR = 1.75, 95% CI: 1.56, 1.96) and anxiolytics (aHR = 1.48, 95% CI: 1.25, 1.73). Compared to non-users of psychotropic medications, those who used 1 type had ~50% higher PD risk, whereas those who used ≥2 types had ~150% higher PD risk. Women who experienced transitions in psychotropic medication use ('use to non-use' or 'non-use to use') between baseline and 3-year follow-up had higher PD risk than those who did not. We obtained similar results with propensity scoring and amongst DASD-diagnosed women. INTERPRETATION: The use of antidepressants, anxiolytics or multiple psychotropic medication types and transitions in psychotropic medication use was associated with increased PD risk, whereas the use of hypnotics was not associated with PD risk amongst older women.
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Neurodegenerative diseases, particularly those involving cognitive decline such as Alzheimer's disease, are frequently accompanied by sleep disturbances, and their coexistence with psychiatric, metabolic, and cardiovascular comorbidities compounds the risk of hypnotic misuse or dependence.
“Neurodegenerative diseases, particularly those involving cognitive decline, such as Alzheimer's disease, are frequently accompanied by sleep disturbances. The coexistence of these disorders with psychiatric, metabolic, and cardiovascular comorbidities compounds the risk of hypnotic misuse or dependence.”
From Z-drug abuse and dependence: Clinical guideline of the Brazilian Academy of Neurology for diagnosis and management (2025) · cites this paper as [58]
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Stelzer, F. G., Bacelar, A., Éckeli, A. L., Negrão, A. B., Almeida, C. M. O., Franco, C. M. R., Pires, G. N., Gitaí, L. L. G., Sobreira-Neto, M. A., Assis, M., et al. (2025) · Arquivos de Neuro-Psiquiatria · doi:10.1055/s-0045-1812323 · Cited by 1 · see citing works
- Authors
- Beydoun, H. A., Saquib, N., Wallace, R. B., Chen, J., Coday, M., Naughton, M. J., Beydoun, M. A., Shadyab, A. H., Zonderman, A. B., & Brunner, R. L.
- Affiliations
- Alexander T. Augusta Military Medical Center (US)
- Sulaiman Al Rajhi Colleges (SA)
- University of Iowa (US)
- University of Southern California (US)
- University of Tennessee Health Science Center (US)
- The Ohio State University (US)
- National Institutes of Health (US)
- University of California San Diego (US)
- University of Nevada, Reno (US)
- Corresponding author
- Beydoun, Hind A.
- ORCID
- Venue
- Annals of Clinical and Translational Neurology
- Publisher
- Wiley
- Published
- 2022-06-24
- Volume
- 9
- Issue
- 8
- Pages
- 1163-1176
- ISSN
- 2328-9503 (ISSN-L)
- PMC
- PMC9380147
- OpenAlex
- W4283362967
- Cited by
- 12
- References
- 49
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 4 · 2022: 1
- FWCI
- 1.32
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Annals of Clinical and Translational Neurology (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc-nd)
- Funders
- U.S. Department of Health and Human Services (75N92021D00002, 75N92021D00005, 75N92021D00004, 75N92021D00001, 75N92021D00003, 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004)
- National Institutes of Health (75N92021D00005, 75N92021D00003, 75N92021D00001, 75N92021D00002, 75N92021D00004)
- National Institute on Aging
- National Heart, Lung, and Blood Institute (75N92021D00005, 75N92021D00004, 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, 75N92021D00005., 75N92021D00003, 75N92021D00002, 75N92021D00001)
- National Institute of Environmental Health Sciences (P30ES005605)
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- Parkinson's disease, psychotropic drugs, antidepressants, anxiolytics, hypnotics, older women, depression, anxiety, sleep disorders, Women's Health Initiative
- MeSH terms
- Aged, Antidepressive Agents, Female, Medicare, Humans, Hypnotics and Sedatives, Parkinson Disease, Psychotropic Drugs, Anti-Anxiety Agents, United States
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