Antiepileptic and psychiatric medication in a nationwide cohort of patients with glioma WHO grade II-IV

J Neurooncol. 2018 Dec;140(3):739-748. doi: 10.1007/s11060-018-03007-9. Epub 2018 Nov 23.

Abstract

Introduction: Glioma is the most common intracranial primary brain tumor. Patients with glioma often suffer from epilepsy, anxiety and depression. Aims of this study were to identify risk factors for drug-treated anxiety and depression, and to determine the use of psychiatric medication in a national glioma cohort.

Methods: Data from the Cancer Registry of Norway on all persons diagnosed with glioma WHO grade II-IV 2004-2010 were linked with data from the Norwegian Prescription Database. Cox regression analysis was used to assess risk factors for drug-treated anxiety and depression. Standardized incidence ratios were calculated for psychiatric medication dispensed to glioma patients and compared to the general population.

Results: The glioma cohort consisted of 1056 males and 772 females. Of the 1828 patients, 565 had glioma grade II-III, and 1263 had grade IV. The patients with glioma grade II-III who were treated with levetiracetam had an increased risk for drug-treated anxiety compared to patients without levetiracetam; hazard ratio 2.8 (95% confidence interval 1.7-4.9). Female gender increased the risk for drug-treated anxiety compared to males in patients with glioma grade IV; hazard ratio 1.5 (95% confidence interval 1.2-2.0). Antidepressants were less frequently dispensed to patients with glioma grade II-III and epilepsy than to the general population.

Conclusions: Patients with glioma grade II-III on levetiracetam had an increased risk for drug-treated anxiety. The subgroup of patients with glioma grade II-III and epilepsy received less antidepressants than the general population.

Keywords: Antiepileptic drugs; Anxiety; Depression; Epilepsy; Glioma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anticonvulsants / adverse effects*
  • Antidepressive Agents / adverse effects*
  • Anxiety / chemically induced*
  • Brain Neoplasms / complications
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / psychology
  • Cohort Studies
  • Depression / chemically induced*
  • Female
  • Glioma / complications
  • Glioma / drug therapy*
  • Glioma / psychology
  • Humans
  • Levetiracetam / adverse effects
  • Male
  • Middle Aged
  • Registries
  • Risk Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Anticonvulsants
  • Antidepressive Agents
  • Levetiracetam