Furthermore, it shows that concomitant use of antidepressants and dopaminergic drugs further increased the risk of hip/femur fractures (ORadj = 3.51, 95% CI = 2.10–5.87). Y-27632 Concomitant current use of dopaminergic drugs and anticholinergics or antipsychotics or benzodiazepines

did not significantly alter the overall risk of hip/femur fractures. Table 3 Current use of dopaminergic drugs and risk of hip/femur fracture by substance and concomitant use of anticholinergics, antidepressants, antipsychotics or benzodiazepines   Cases (n = 6,763) Controls (n = 26,341) Crude OR [95% CI] ORadj a [95% CI] Among current users of a dopaminergic drug          By substance          Dopamine agonist alone 5 (0.1) 7 (0.0) 2.86 [0.91−9.00] 1.86 [0.56−6.19]  Levodopa alone 117 (1.7) 188 (0.7) 2.46 [1.95−3.11] 1.71 [1.32−2.21]  Combination of dopamine agonist and levodopa 34 (0.5) 42 (0.2) 3.28 [2.09−5.16] 1.98 [1.20−3.26]  By concomitant useb          Anticholinergicsc          Yes 16 (0.2) 28 (0.1) 2.27 [1.23−4.20] 1.59 [0.83−3.05] (a)  No 140 (2.1) 209 (0.8) 2.67 [2.14−3.32] 1.89 [1.49−2.41] (a)  Antidepressants          Yes 31 (0.5) 30 (0.1) 4.16 [2.52−6.88] 3.51 [2.10−5.87]d (b)  No 125 (1.8) 207 (0.8) 2.40 [1.91−3.00] 1.70 [1.31−2.20] (b)  Antipsychotics          Yes 17 (0.3) 29 (0.1) 2.29 [1.25−4.20] 1.43 [0.74−2.77]  No 139

(2.1) 208 (0.8) 2.67 [2.14−3.32] 1.80 [1.40−2.30]  Benzodiazepines          Yes 23 (0.3) 32 (0.1) 2.88 [1.68−4.92] 1.87 [1.07−3.28]  No 133 (2.0) 205 (0.8) 2.58 [2.06−3.22] 1.74 [1.35−2.24] this website aAdjusted for the same confounders as under Table 2 ((a) except for anticholinergics, Bacterial neuraminidase (b) except for antidepressants) bConcomitant current use (1−30 days before the index date) cAnticholinergics include biperiden,

dexetimide, orphenadrine, procyclidine and trihexyphenidyl d p = 0.011 for concomitant versus no concomitant use of antidepressants Figure 1 shows that hip/femur fracture risk was increased immediately after initiation of dopaminergic drug therapy and that it remained more than twofold increased during more than 6 years of continuous use. There were no significant differences between current users of a dopaminergic drug with a duration ≤1 year (ORadj = 1.87, 95% CI = 1.29–2.73) and current users who had been taking the dopaminergic drug >1 year (ORadj = 1.69, 95% CI = 1.28–2.25). Figure 2 shows that after discontinuation of dopaminergic treatment, the increased risk of hip/femur fractures rapidly decreased and that it was no longer increased after 1 year of discontinuation. Fig. 1 The risk of hip/femur fracture with continuous duration of dopaminergic drug use among current users. Datapoints and spline regression line represent adjusted OR (adjusted for the same confounders as under Table 2) Fig. 2 The risk of hip/femur fracture and time since last dispensing for a dopaminergic drug.