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Antidepressant Use at the Threshold: using electronic health records to characterise people prescribed antidepressants around the time of dementia diagnosis
Heybe M, Verma S, Moyano BP, Stewart R, Mueller C, Davis KAS.. medRxiv, 2025-12-17
Topic: Health services, long-term care and technology
Background Antidepressant use is common in people with dementia. Antidepressants may be started to manage symptoms of dementia, rather than depressive and anxiety disorders. We hypothesised people prescribed antidepressants around the time of dementia diagnosis may have different characteristics from those with longstanding prescriptions. Methods We used linked primary care (Lambeth DataNet) and specialist (Clinical Record Interactive Search) data for patients with dementia in south London, UK. Antidepressant prescription was ascertained, and a new start was within one year before or after dementia diagnosis. Coded fields, a rating scale for neuropsychiatric symptoms and natural language processing of full-text were used to describe depression and anxiety. Results Of 3,713 patients with dementia, 28% were prescribed antidepressants within the year of dementia diagnosis, and 42% of these were new start prescriptions. Compared to the no antidepressant group, the new start group were more likely to be female, have vascular dementia and neuropsychiatric symptoms. Compared to the long-standing group, new start had fewer comorbidities; people from non-White ethnicities were more likely to lack documentation of depression or anxiety. Deprescribing was equally unlikely in new and long-term prescriptions (6.3% vs 5.5% per year of follow-up). Conclusions The high incidence of new prescribing, as well as the lack of deprescribing, points to unmet needs and a role for more proactive medication review. Further studies should include the clinician and patient voices to further understand how to improve non-pharmacological support for people at the threshold of dementia.
Key findings
- Results Of 3,713 patients with dementia, 28% were prescribed antidepressants within the year of dementia diagnosis, and 42% of these were new start prescriptions.
- Compared to the no antidepressant group, the new start group were more likely to be female, have vascular dementia and neuropsychiatric symptoms.
- Compared to the long-standing group, new start had fewer comorbidities; people from non-White ethnicities were more likely to lack documentation of depression or anxiety.
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Study details
- Participants3,713
- Effect size6.3%; 5.5%
- Evidence strengthLow
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 32 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 20 of the 62 points we could judge it on, which is 32 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 3 / 4 | 3,713 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 20 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 20 of the 62 points we could judge it on is 32 out of 100. |
| Total | 32 / 100 | Capped to 16 because this is not a peer-reviewed article. |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Heybe, M., Verma, S., Moyano, B. P., Stewart, R., Mueller, C., & Davis, K. A. S. (2025). Antidepressant Use at the Threshold: using electronic health records to characterise people prescribed antidepressants around the time of dementia diagnosis. medRxiv. https://doi.org/10.64898/2025.12.16.25342379
Vancouver
Heybe M, Verma S, Moyano BP, Stewart R, Mueller C, Davis KAS. Antidepressant Use at the Threshold: using electronic health records to characterise people prescribed antidepressants around the time of dementia diagnosis. medRxiv. 2025. doi:10.64898/2025.12.16.25342379.
BibTeX
@article{heybe2025-229b859c,
author = {Heybe, M. and Verma, S. and Moyano, B. P. and Stewart, R. and Mueller, C. and Davis, K. A. S.},
title = {{Antidepressant Use at the Threshold: using electronic health records to characterise people prescribed antidepressants around the time of dementia diagnosis}},
journal = {medRxiv},
year = {2025},
doi = {10.64898/2025.12.16.25342379},
url = {https://doi.org/10.64898/2025.12.16.25342379}
}
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