Dunn N R, Freemantle S N, Mann R D
Drug Safety Research Unit, Bursledon Hall, Southampton SO31 1AA, UK.
Br J Clin Pharmacol. 1999 Aug;48(2):230-3. doi: 10.1046/j.1365-2125.1999.00982.x.
Some reports have suggested that calcium channel blockers may be associated with an increased incidence of depression or suicide. There is a paucity of evidence from large scale studies. The aim of this study was to assess rates of depression with calcium channel antagonists using data from prescription event monitoring studies.
Observational studies on large cohorts of patients using lisinopril, enalapril (ACE inhibitors), nicardipine (type 2 calcium channel blocker) and diltiazem (type 3 calcium channel blocker) were conducted, using prescription-event monitoring. Rates of depression in the different drugs and rate ratios (95% CI) were computed.
The crude overall rates of depression during treatment were 1.89, 1.92 and 1.62 per 1000 patient months for the ACE inhibitors, diltiazem and nicardipine, respectively. Using the ACE inhibitors as the reference group, the rate ratios for depression were 1.07 (0. 82-1.40) and 0.86 (0.69-1.08) for diltiazem and nicardipine, respectively.
This study does not support the hypothesis that calcium channel blockers are associated with depression, when considering patients treated in general practice in the UK.
一些报告表明钙通道阻滞剂可能与抑郁症或自杀发生率增加有关。大规模研究的证据不足。本研究的目的是利用处方事件监测研究的数据评估使用钙通道拮抗剂时的抑郁症发生率。
采用处方事件监测,对大量使用赖诺普利、依那普利(血管紧张素转换酶抑制剂)、尼卡地平(2型钙通道阻滞剂)和地尔硫䓬(3型钙通道阻滞剂)的患者队列进行观察性研究。计算不同药物的抑郁症发生率和率比(95%可信区间)。
血管紧张素转换酶抑制剂、地尔硫䓬和尼卡地平治疗期间抑郁症的总体粗发生率分别为每1000患者月1.89、1.92和1.62。以血管紧张素转换酶抑制剂作为参照组,地尔硫䓬和尼卡地平抑郁症的率比分别为1.07(0.82 - 1.40)和0.86(0.69 - 1.08)。
在考虑英国全科医疗中接受治疗的患者时,本研究不支持钙通道阻滞剂与抑郁症有关的假设。