Thiessen B Q, Wallace S M, Blackburn J L, Wilson T W, Bergman U
College of Pharmacy, University of Saskatchewan, Saskatoon, Canada.
Arch Intern Med. 1990 Nov;150(11):2286-90.
Using records of the Saskatchewan Prescription Drug Plan, we determined the incidence of antidepressant use (a marker for depressive symptoms) in patients who received beta-blockers or other treatments for chronic diseases (diuretics, antihypertensives, and hypoglycemics) during 1984, but not in the previous 6 months. Antidepressants initiated within 12 months after the study drug were counted. Of the 3218 new beta-blocker users, 6.4% received concurrent prescriptions (ie, within 34 days) for an antidepressant and beta-blocker. Only 2.8% of the reference group (no study drug use) received an antidepressant. A greater proportion of patients prescribed propranolol (9.5%) received an antidepressant than those prescribed other "lipophilic" (3.9%) or "hydrophilic" (2.5%) beta-blockers. Incidence ratios for propranolol revealed the overall risk antidepressant use was 4.8 (95% confidence interval [CI], 4.1 to 5.5) times that of the reference group and 2.1 (95% CI, 1.7 to 2.5) times that of all other study drug users. For propranolol, relative risk of antidepressant use (drug/reference group) varied with age and was greatest in the 20- to 39-year-old group (17.2; 95% CI, 13.7 to 21.5).
利用萨斯喀彻温省处方药计划的记录，我们确定了在1984年接受β受体阻滞剂或其他慢性病治疗药物（利尿剂、抗高血压药和降血糖药）但在之前6个月未接受此类治疗的患者中，使用抗抑郁药（抑郁症状的一个指标）的发生率。统计在研究药物使用后12个月内开始使用的抗抑郁药。在3218名新的β受体阻滞剂使用者中，6.4%同时开具了抗抑郁药和β受体阻滞剂的处方（即34天内）。对照组（未使用研究药物）中只有2.8%的人使用了抗抑郁药。与使用其他“亲脂性”（3.9%）或“亲水性”（2.5%）β受体阻滞剂的患者相比，使用普萘洛尔的患者中使用抗抑郁药的比例更高（9.5%）。普萘洛尔的发生率比值显示，使用抗抑郁药的总体风险是对照组的4.8倍（95%置信区间[CI]，4.1至5.5），是所有其他研究药物使用者的2.1倍（95%CI，1.7至2.5）。对于普萘洛尔，使用抗抑郁药的相对风险（药物/对照组）随年龄而异，在20至39岁年龄组中最高（17.2；95%CI，13.7至21.5）。
