Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
J Pharm Pharm Sci. 2019;22(1):57-71. doi: 10.18433/jpps30129.
Studies provided conflicting results on whether antidepressant use increased the risk of venous thromboembolism (VTE). Our aim was to examine the association between antidepressant use and the risk of VTE.
Pubmed, Embase, and the Cochrane Library were searched up to March 13, 2018. Case-control studies and cohort studies that examined the association between antidepressant use and the risk of VTE, deep vein thrombosis or pulmonary embolism were included. Several subgroup analyses and sensitivity analyses were conducted. GRADE approach was used to assess the quality of evidence.
Nine studies (six case-control studies and three cohort studies) were included. Overall, antidepressant use may be associated with an increased risk of VTE (OR 1.27, 95% CI 1.09 to 1.49); however, no association was observed in studies with low risk of bias (OR 1.27, 95% CI 0.84 to 1.92). No association between selective serotonin reuptake inhibitor use and VTE risk was detected in the overall analysis (OR 1.10, 95% CI 0.90 to 1.34) and in subgroup analysis of studies with low risk of bias. Tricyclic antidepressant may be associated with an increased VTE risk (OR 1.26, 95% CI 1.02 to 1.57), and the quality of evidence was rated as very low by GRADE approach; however, no association was observed when we only included studies with low risk of bias.
There was no association between selective serotonin reuptake inhibitor use and VTE risk. Tricyclic antidepressant may be associated with an increased VTE risk, but the quality of evidence was very low.
有研究对使用抗抑郁药是否会增加静脉血栓栓塞（VTE）风险得出了相互矛盾的结果。我们旨在研究使用抗抑郁药与 VTE 风险之间的关联。
我们检索了 Pubmed、Embase 和 Cochrane 图书馆，检索截至 2018 年 3 月 13 日。纳入了研究抗抑郁药使用与 VTE、深静脉血栓形成或肺栓塞风险之间关联的病例对照研究和队列研究。进行了几项亚组分析和敏感性分析。使用 GRADE 方法评估证据质量。
纳入了 9 项研究（6 项病例对照研究和 3 项队列研究）。总体而言，使用抗抑郁药可能与 VTE 风险增加相关（OR 1.27，95%CI 1.09 至 1.49）；但是，在低偏倚风险的研究中未观察到相关性（OR 1.27，95%CI 0.84 至 1.92）。在总体分析和低偏倚风险研究的亚组分析中，未发现选择性 5-羟色胺再摄取抑制剂使用与 VTE 风险之间存在关联（OR 1.10，95%CI 0.90 至 1.34）。三环类抗抑郁药可能与 VTE 风险增加相关（OR 1.26，95%CI 1.02 至 1.57），GRADE 方法评价证据质量为极低；但是，当我们仅纳入低偏倚风险的研究时，未观察到相关性。
选择性 5-羟色胺再摄取抑制剂使用与 VTE 风险之间无关联。三环类抗抑郁药可能与 VTE 风险增加相关，但证据质量极低。
