Hemorrhagic stroke associated with antidepressant use in patients with depression: does degree of serotonin reuptake inhibition matter?
Hemorrhagic stroke associated with antidepressant use in patients with depression: does degree of serotonin reuptake inhibition matter?
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DOI：
10.1002/pds.1699
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发表时间：
2009-03-01
影响因子：
2.6
通讯作者：
Patel, Nick C.
中科院分区：
文献类型：
--
作者：
Chen, Yan;Guo, Jeff J.;Patel, Nick C.
目的本研究旨在确定血清素（5-HT）再摄取抑制程度是否会影响抑郁症患者使用抗抑郁药相关的出血性中风风险。方法使用管理式医疗索赔数据库进行了一项基于人群的巢式病例对照研究。 92 名被诊断为出血性中风的抑郁症患者被识别出来，并按年龄、性别和抑郁症索引日期 (IDD) 年份与 552 名对照者进行匹配。使用 ICD-9 代码对抑郁症、出血性中风和其他合并症进行诊断。根据抗抑郁药与 5-HT 再摄取转运蛋白的亲和力，抗抑郁药被分为高、中或低再摄取抑制，使用其各自的平衡解离常数 (K(D)；高：K(D) < 1 nM；中：1 = 10 nM）。采用条件逻辑回归分析来估计出血性中风风险的粗略比值比 (OR) 和调整后比值比 (OR) 以及 95% 置信区间 (CI)。结果 与未使用抗抑郁药的患者相比，曾经使用过抗抑郁药的患者之间出血性中风的风险没有显着差异，高（OR = 0.82；95% CI = 0.44-1.55）、中（OR = 0.93；95% CI = 0.37-2.3 1)，或低（OR = 0.38；95% CI = 0.11-1.41）5-HTT 抑制。 结论 与抗抑郁药使用相关的出血性中风风险可能与抗抑郁药的 5-HT 再摄取抑制程度无关。鉴于本研究的局限性，需要进行更多研究来证实这些发现。版权所有 (C) 2008 约翰·威利父子有限公司
Objective This study aimed to determine whether the degree of serotonin (5-HT) reuptake inhibition affects risk of hemorrhagic stroke associated with antidepressant use in patients with depression.Method A population-based, nested case-control study was performed using a managed care medical claims database. Ninety two depressed patients with a diagnosis of hemorrhagic stroke were identified and matched with 552 controls by age, sex, and year of index date of depression (IDD). Diagnoses of depression, hemorrhagic stroke, and other medical comorbidities were identified using ICD-9 codes. Antidepressants were classified as high, medium, or low reuptake inhibition based on their affinities for the 5-HT reuptake transporter, determined using their respective equilibrium dissociation constants(K(D); high: K(D) < 1 nM; medium: 1 = 10 nM). Conditional logistic regression analysis was performed to estimate the crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of the risk of hemorrhagic stroke.Results Compared to non-users of antidepressants, risk of hemorrhagic stroke did not significantly differ between patients who had ever used antidepressants with high (OR = 0.82; 95% CI = 0.44-1.55), medium (OR = 0.93; 95% CI = 0.37-2.3 1), or low (OR = 0.38; 95% CI = 0.11-1.41) 5-HTT inhibition.Conclusion Risk of hemorrhagic stroke associated with antidepressant use may not be related to an antidepressant's degree of 5-HT reuptake inhibition. Given the limitations of this study, additional studies are needed to confirm these findings. Copyright (C) 2008 John Wiley & Sons, Ltd.