Endocrine Abstracts

Objective: Several autoimmune disorders are known to be associated with an increased risk of psychiatric morbidity. Yet, the effect of autoimmune Addison’s disease (AAD) on mental health is not well known. The aim of this study was to examine the use of psychotropic drugs around diagnosis in Swedish individuals with AAD.

Design and methods: In this population-based cohort study, The Swedish national patient register, and the Swedish Addison register were used to find cases with AAD. The Swedish population register was then used to find matched controls. Information on psychotropic drugs prescribed between July 2006 and December 2019 was retrieved from the Swedish prescribed drug register. The primary outcomes were dispensations of antipsychotics (ATC N05A), anxiolytics (ATC N05B), hypnotics/sedatives (ATC N05C) and/or antidepressants (ATC N06A), from three years before to three years after AAD diagnosis in the national patient register.

Results: 963 cases of AAD and 9366 matched controls were identified. The most dispensed type of psychotropic medication was hypnotics and sedatives, with 14.2% of cases receiving it during the year of most use. The least dispensed group of psychotropics was anti-psychotics, with only 2.0% of cases and 1.8% of controls receiving it at most. Anti-depressants were prescribed at a lower frequency to the AAD group at all time points except for during the year before diagnosis, where the incidence was higher than in the control group (aOR 1.24; 95% CI 1.02–1.55; P=0.040). Patients also received more anxiolytics the year before diagnosis (aOR 1.28; 95% CI 1.03–1.62; P=0.039). Hypnotics and sedatives were significantly more common after diagnosis (aOR 1.29; 95% CI 1.02–1.64; P=0.036) and the increase did not subside during the study period.

Conclusion: Individuals with AAD receive more anxiolytics, anti-depressants, sedatives and hypnotics around diagnosis. While the dispensation of anxiolytics and anti-depressants return to pre-diagnostic levels after a while, the increased dispensation of sedatives and hypnotics remains elevated.