Pharmacotherapy:老年抑郁患者使用帕罗西汀是否增加死亡风险?

2017-04-20 常路 环球医学

选择性5-羟色胺再摄取抑制剂中,帕罗西汀是一种强烈的抗胆碱能药物,可造成较高的不良结局风险。2017年3月,发表在《Pharmacotherapy.》的一项研究调查了使用帕罗西汀和其他选择性5-羟色胺再摄取抑制剂的老年疗养院抑郁患者的死亡风险。目的:选择性5-羟色胺再摄取抑制剂(SSRIs)中,帕罗西汀是一种强烈的抗胆碱能药物,可造成较高的不良结局风险,如死亡。本研究检测了使用帕罗西汀和其他SSR

选择性5-羟色胺再摄取抑制剂中,帕罗西汀是一种强烈的抗胆碱能药物,可造成较高的不良结局风险。2017年3月,发表在《Pharmacotherapy.》的一项研究调查了使用帕罗西汀和其他选择性5-羟色胺再摄取抑制剂的老年疗养院抑郁患者的死亡风险。

目的:选择性5-羟色胺再摄取抑制剂(SSRIs)中,帕罗西汀是一种强烈的抗胆碱能药物,可造成较高的不良结局风险,如死亡。本研究检测了使用帕罗西汀和其他SSRIs的老年疗养院抑郁患者的死亡风险。

方法:本研究使用了2007~2010年链接到医疗保险的最小数据集的数据和倾向得分(PS)匹配的回顾性队列研究设计来实现本研究的目的。帕罗西汀和其他SSRIs的新使用者随访到随访末期(1年)、转换到不同的抗抑郁药种类、使用心理治疗、指数抗抑郁药种类的使用有超过15天的间隔,随访结束以上述的任何一个先发生为准。稳健Cox成比例风险(PH)模型用于评估与老年疗养院抑郁患者使用帕罗西汀和其他SSRI相关的死亡风险。

结果:PS匹配产生了两治疗组的每组4620名患者。配对队列中,帕罗西汀和其他SSRIs使用者的未调整死亡率分别为269(2.9%)和288(3.1%)。稳健Cox PH模型未发现两组死亡风险存在任何显着性差异(风险比,1.01;95% CI,0.86~1.19)。

结论:老年疗养院抑郁患者中,本研究未发现帕罗西汀和其他SSRIs使用者间,在死亡风险上存在任何显着性差异。由于帕罗西汀在老年人群中的抗胆碱能作用,因此需要进一步评估帕罗西汀的其他不良反应。

原始出处:

Bali V, Chatterjee S, Johnson ML,et al. Risk of Mortality in Elderly Nursing Home Patients with Depression Using Paroxetine. Pharmacotherapy. 2017 Mar.

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    2018-04-01 yb6560
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    2017-09-11 jj000001
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