(256) Treatment Patterns for Depression and Anxiety Among Patients with Progressive Supranuclear Palsy (PSP)

Publication Number: 587

Background: Progressive supranuclear palsy (PSP) is a rare, progressive neurological disease that impacts mobility, cognitive function, speech and vision. Limited treatment options are available to manage symptoms. Life expectancy is approximately 7 years from symptom onset. Comorbid mood disorders are common with PSP but are not well understood, and limited data exists on treatment patterns with regards to medications for depression and anxiety with PSP. Our study seeks to better understand these patterns.

Objectives: To describe treatment patterns of 50 patients diagnosed with PSP across North America, specifically for patients who are also taking medications to treat depression and/or anxiety.

Methods: We conducted a retrospective cohort study of 50 patients with a clinical diagnosis of PSP. Using a novel research platform, complete and deidentified medical records were requested, digitized, and abstracted by trained clinical abstractors. Date of records acquired ranged from 1997-2021, and medical records were sourced from 133 care centers. The analysis included medications with an indication for depression, anxiety, or other mood disorder. Descriptive statistics were used to convey cohort characteristics and longitudinal medication use.

Results: In the cohort of 50 patients diagnosed with PSP, 52% were female and 48% were male. Mean age at diagnosis for these groups was 66 and 67 years, respectively. Mean range of available records for patients was 8 years, with the average record dated less than a year before diagnosis. 28% of patients were diagnosed with anxiety, 38% were diagnosed with depression, and 8% were diagnosed with an unspecified mood disorder (58% combined across conditions).

23 patients were prescribed 18 depression or anxiety indicated medications, with ongoing use of 23 of the 34 prescriptions. The most common type of drug prescribed for anxiety, depression, or mood disorder were SSRIs (n = 11) and benzodiazepines (n = 11), followed by atypical antidepressants (n = 7), SNRIs (n = 4), and antipsychotics (n = 1). The median duration of use for a depression or anxiety medication was 491 days. Most patients were prescribed 1 depression or anxiety medication, 5 were prescribed 2 medications, and 3 were prescribed 3 during the study period. The most common medication class with an ongoing prescription was SSRIs.

Conclusions: Use of medication for mood in PSP is common and increases over the course of disease despite limited understanding of, or guidelines related to, their usage with PSP. Results from this study provide greater insight into how patients with PSP are treated for mental health conditions and highlight the need to further understand and consider how anxiety and depression are managed in rare, neurodegenerative disease.