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[抗抑郁药物的使用与高血糖和糖尿病的发生:一项日本药品不良事件报告数据库研究]

[Antidepressant Medication Use and Development of Hyperglycemia and Diabetes Mellitus: A Japanese Adverse Drug Event Report Database Study].

作者信息

Mukai Junichi, Maruyama Saki, Otori Katsuya, Kubota Rie

机构信息

Division of Clinical Pharmacy (Laboratory of Clinical Pharmacy Education) and Research and Education Center for Clinical Pharmacy, School of Pharmacy, Kitasato University.

Division of Clinical Pharmacy (Laboratory of Pharmacy Practice and Science IV) and Research and Education Center for Clinical Pharmacy, School of Pharmacy, Kitasato University.

出版信息

Yakugaku Zasshi. 2020;140(4):591-598. doi: 10.1248/yakushi.19-00196.

DOI:10.1248/yakushi.19-00196
PMID:32238642
Abstract

Few studies have examined the relationship between the use of antidepressants and the onset of hyperglycemia and diabetes mellitus in Japan. We herein explored the possibility of this relationship using the Japanese Adverse Drug Event Report database (JADER). The present study included 20 individual antidepressants, consisting of 6 subclasses, which have been approved for use in Japan. We used Standardized MedDRA Queries 20000041 to extract patients who developed hyperglycemia/new onset diabetes mellitus (NODM) in JADER between April 2004 and September 2016. We calculated reporting odds ratios (RORs) with 95% confidence intervals (CI). We also calculated odds ratios defined as the ratio of odds of hyperglycemia/NODM to all other adverse drug events (ADEs) by the age cut-off group or sex in the cases of antidepressants. The lower limit of 95%CI of RORs for 13 antidepressants (imipramine, clomipramine, nortriptyline, amitriptyline, amoxapine, maprotiline, mianserin, sertraline, paroxetine, escitalopram, duloxetine, mirtazapine, and trazodone), which included all subclasses, exceeded 1. Younger age group was associated with hyperglycemia/NODM for 5 antidepressants (imipramine, amitriptyline, maprotiline, duloxetine, and trazodone), and female was associated with the ADEs for trazodone, although these results should be interpreted cautiously. Healthcare personnel need to be aware that the use of antidepressants may lead to hyperglycemia/NODM.

摘要

在日本,很少有研究探讨抗抑郁药的使用与高血糖和糖尿病发病之间的关系。我们在此使用日本药品不良反应事件报告数据库(JADER)来探究这种关系的可能性。本研究纳入了20种已在日本获批使用的抗抑郁药,它们由6个亚类组成。我们使用标准化医学术语词典查询20000041从JADER中提取2004年4月至2016年9月期间出现高血糖/新发糖尿病(NODM)的患者。我们计算了报告比值比(ROR)及其95%置信区间(CI)。我们还计算了抗抑郁药按年龄分组或性别划分的高血糖/NODM与所有其他药品不良反应(ADE)的比值比。13种抗抑郁药(丙咪嗪、氯米帕明、去甲替林、阿米替林、阿莫沙平、马普替林、米安色林、舍曲林、帕罗西汀、艾司西酞普兰、度洛西汀、米氮平和曲唑酮)的ROR的95%CI下限超过了1,这13种抗抑郁药涵盖了所有亚类。5种抗抑郁药(丙咪嗪、阿米替林、马普替林、度洛西汀和曲唑酮)的年轻年龄组与高血糖/NODM相关,曲唑酮的ADE与女性相关,不过这些结果应谨慎解读。医护人员需要意识到使用抗抑郁药可能会导致高血糖/NODM。

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