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抗抑郁药的使用与癫痫发作风险:观察性研究的荟萃分析。

Antidepressant use and the risk of seizure: a meta-analysis of observational studies.

作者信息

Yang Wei, Jia Yong-Hui, Jiang Hai-Yin, Li Ai-Juan

机构信息

Department of Oncology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China.

Pharmacy Department, The 960th Hospital of PLA, Jinan, China.

出版信息

Eur J Clin Pharmacol. 2024 Feb;80(2):175-183. doi: 10.1007/s00228-023-03597-y. Epub 2023 Nov 24.

Abstract

PURPOSE

The association between antidepressant use and the risk of seizures remains controversial. Therefore, this meta-analysis examined whether antidepressant use affects the risk of seizures.

METHODS

To identify relevant observational studies, we conducted systematic searches in PubMed and Embase of studies published through May 2023. Random-effects models were used to estimate overall relative risk.

RESULTS

Our meta-analysis included eight studies involving 1,709,878 individuals. Our results showed that selective serotonin reuptake inhibitors (SSRI) (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.32-1.66; P < 0.001) and selective noradrenalin reuptake inhibitors (SNRI) (OR 1.65, 95% CI 1.24-2.19; P = 0.001), but not tricyclic antidepressants (TCA) (OR 1.27, 95% CI 0.84-1.92; P = 0.249), were associated with an increased risk of seizures. Subgroup analyses revealed an OR of 2.35 (95% CI 1.7, 3.24; P < 0.001) among short-term (< 30 days) antidepressant users.

CONCLUSIONS

The findings of this meta-analysis support an increased risk of seizures in new-generation antidepressant users, expanding previous knowledge by demonstrating a more pronounced risk in short-term users.

摘要

目的

抗抑郁药的使用与癫痫发作风险之间的关联仍存在争议。因此,本荟萃分析探讨了使用抗抑郁药是否会影响癫痫发作风险。

方法

为了识别相关的观察性研究,我们在PubMed和Embase中对截至2023年5月发表的研究进行了系统检索。采用随机效应模型来估计总体相对风险。

结果

我们的荟萃分析纳入了八项研究,涉及1,709,878名个体。我们的结果显示,选择性5-羟色胺再摄取抑制剂(SSRI)(优势比[OR]1.48,95%置信区间[CI]1.32 - 1.66;P < 0.001)和选择性去甲肾上腺素再摄取抑制剂(SNRI)(OR 1.65,95% CI 1.24 - 2.19;P = 0.001)与癫痫发作风险增加相关,但三环类抗抑郁药(TCA)(OR 1.27,95% CI 0.84 - 1.92;P = 0.249)则不然。亚组分析显示,短期(< 30天)使用抗抑郁药的人群中优势比为2.35(95% CI 1.7,3.24;P < 0.001)。

结论

本荟萃分析的结果支持新一代抗抑郁药使用者癫痫发作风险增加,通过证明短期使用者风险更为显著扩展了先前的认知。

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