Department of Surgery, Western University, London, Ontario, Canada.
ICES, London, Ontario, Canada.
Pharmacoepidemiol Drug Saf. 2020 Dec;29(12):1710-1714. doi: 10.1002/pds.5147. Epub 2020 Oct 15.
Prior research has suggested that anticholinergic medications used for overactive bladder are associated with depression. Our objective was to test this hypothesis by comparing rates of new onset depression among anticholinergic medication users and those who were prescribed an alternative class of overactive bladder medication.
We used administrative data records from the province of Ontario, Canada and a matched cohort design. We matched patients who were newly prescribed an oral anticholinergic to those prescribed a beta-3 agonist medication in a 2:1 ratio which included a propensity score that incorportated 75 baseline characteristics. The primary outcome of depression was measured using a validated definition, and the at-risk period for our outcome of interest was between the initial date the prescription was filled, and up to 3 months after the end of continuous usage of that medication. Hazard ratios (HRs) were estimated using Cox proportional hazards regression.
We matched 23 622 beta-3 agonist users (mirabegron) to 47 324 anticholinergic users (most commonly tolterodine, oxybutynin, and solifenacin). The rate of depression was similar among beta-3 agonist users (11.2 per 1000 patient-years) and anticholinergic users (11.9 per 1000 patient-years). In our primary analysis, the risk of depression among anticholinergic users was not significantly different compared to beta-3 agonist users (HR 1.08 [95% CI 0.92-1.28, P = .35]).
Contrary to a previous report, overactive bladder anticholinergic medications do not appear to be associated with new onset depression.
先前的研究表明，用于治疗膀胱过度活动症的抗胆碱能药物与抑郁症有关。我们的目的是通过比较抗胆碱能药物使用者和被开处另一种类型的膀胱过度活动症药物的患者中新发抑郁症的发生率来验证这一假设。
我们使用了来自加拿大安大略省的行政数据记录和匹配队列设计。我们以 2:1 的比例将新开口服抗胆碱能药物的患者与开处β-3 激动剂药物的患者相匹配，其中包括一个纳入 75 个基线特征的倾向评分。使用经过验证的定义来衡量抑郁症的主要结局，我们感兴趣的结局的风险期为处方首次填写日期至该药物连续使用结束后 3 个月之间。使用 Cox 比例风险回归估计风险比（HRs）。
我们将 23622 名β-3 激动剂使用者（米拉贝隆）与 47324 名抗胆碱能药物使用者（最常见的托特罗定、奥昔布宁和索利那新）相匹配。β-3 激动剂使用者（11.2 例/1000 患者年）和抗胆碱能药物使用者（11.9 例/1000 患者年）的抑郁症发生率相似。在我们的主要分析中，与β-3 激动剂使用者相比，抗胆碱能药物使用者发生抑郁症的风险没有显著差异（HR 1.08 [95% CI 0.92-1.28，P = 0.35]）。
与之前的报告相反，膀胱过度活动症抗胆碱能药物似乎与新发抑郁症无关。
