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Abstract
Objective To determine whether tetrabenazine (TBZ) use is associated with an increased incidence of depression and/or suicidal ideation.
Methods In this retrospective cross-sectional study of the Enroll-HD database, we used multiple logistic regression analyses to determine whether TBZ use is associated with an increased incidence of depression and/or suicidal ideation. For both dependent variables (depression and suicidality), separate analyses were conducted on (1) all participants, (2) only participants with a history of depression, and (3) only participants with no history of depression. Adjustments were made for CAG repeat length, total motor score, total functional capacity, Symbol Digit Modalities Test score, sex, disease duration, history of depression (when applicable), antipsychotic use, and antidepressant use.
Results Compared to participants who were not using TBZ (n = 3,548), TBZ users (n = 543) did not have an increased risk of depression (odds ratio [OR] = 0.78, p = 0.064). Participants taking TBZ actually had a relatively lower risk of suicidality (OR = 0.61, p = 0.043). Among only participants with a history of depression, those using TBZ had a lower incidence of depression (OR = 0.71, p = 0.016) and suicidal ideation (OR = 0.57, p = 0.028) compared to those not using TBZ. Finally, among only participants with no history of depression, TBZ use was not associated with a higher incidence of depression (OR = 1.59, p = 0.18) or suicidality (OR = 1.43, p = 0.66) compared to those who were not using TBZ.
Conclusions TBZ use was not associated with an increased incidence of depression or suicidality. These findings suggest that TBZ may be safe to use in patients with Huntington disease who have a history of depression.
Glossary
- ANCOVA=
- analysis of covariance;
- HD=
- Huntington disease;
- OR=
- odds ratio;
- PBA=
- Problem Behaviors Assessment;
- TBZ=
- tetrabenazine;
- TFC=
- total functional capacity;
- VMAT-2=
- vesicular monoamine transporter type 2
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
CME Course: NPub.org/cmelist
- Received November 22, 2017.
- Accepted in final form April 11, 2018.
- © 2018 American Academy of Neurology
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Letters: Rapid online correspondence
- Author response to Sampaio et al.
- Reader response: Evaluating depression and suicidality in tetrabenazine users with Huntington disease
- Author response to Dr. Aziz: Confounding-by-indication
- Tetrabenazine, depression, and suicidality in Huntington disease
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