Yang Wei, Jia Yong-Hui, Jiang Hai-Yin, Li Ai-Juan
Department of Oncology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China.
Pharmacy Department, The 960th Hospital of PLA, Jinan, China.
Eur J Clin Pharmacol. 2024 Feb;80(2):175-183. doi: 10.1007/s00228-023-03597-y. Epub 2023 Nov 24.
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.
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.
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.
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.
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。
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。
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)。
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。