Abstract
We evaluated the relationship between new selective serotonin reuptake inhibitor (SSRI) or serotonin–noradrenaline reuptake inhibitor (SNRI) drug use and respiratory-related morbidity and mortality among older adults with chronic obstructive pulmonary disease (COPD).
This was a retrospective population-based cohort study using heath administrative data from Ontario, Canada. Individuals aged ≥66 years, with validated, physician-diagnosed COPD (n=131 718) were included. New SSRI/SNRI users were propensity score matched 1:1 to controls on 40 relevant covariates to minimise potential confounding.
Among propensity score matched community-dwelling individuals, new SSRI/SNRI users compared to non-users had significantly higher rates of hospitalisation for COPD or pneumonia (hazard ratio (HR) 1.15, 95% CI 1.05–1.25), emergency room visits for COPD or pneumonia (HR 1.13, 95% CI 1.03–1.24), COPD or pneumonia-related mortality (HR 1.26, 95% CI 1.03–1.55) and all-cause mortality (HR 1.20, 95% CI 1.11–1.29). In addition, respiratory-specific and all-cause mortality rates were higher among long-term care home residents newly starting SSRI/SNRI drugs versus controls.
New use of serotonergic antidepressants was associated with small, but significant, increases in rates of respiratory-related morbidity and mortality among older adults with COPD. Further research is needed to clarify if the observed associations are causal or instead reflect unresolved confounding.
Abstract
Serotonergic antidepressants are associated with increased adverse respiratory outcomes in older adults with COPD http://ow.ly/E5ex30khSLq
Footnotes
This article has supplementary material available from erj.ersjournals.com
Conflict of interest: D.E. O'Donnell reports grants and personal fees from Boehringer Ingelheim, AstraZeneca and GlaxoSmithKline, and personal fees from Novartis, Pfizer and Almirall, outside the submitted work.
Support statement: This research was funded by the University of Toronto, Pettit Respirology Block Term Grant. This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. Parts of this material are based on data and information compiled and provided by Canadian Institute for Health Information (CIHI). However, the analyses, conclusions, opinions and statements expressed herein are those of the author, and not necessarily those of CIHI. Parts of this material are based on data and information provided by Cancer Care Ontario (CCO). The opinions, results, view, and conclusions reported in this paper are those of the authors and do not necessarily reflect those of CCO. No endorsement by CCO is intended or should be inferred. P.C. Austin was supported in part by a Career Investigator Award from the Heart and Stroke Foundation. A.S. Gershon was supported in part by a Canadian Institutes of Health Research New Investigator Award. P.A. Rochon holds the Retired Teachers of Ontario/ERO Chair in Geriatric Medicine at the University of Toronto. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received March 7, 2018.
- Accepted May 28, 2018.
- Copyright ©ERS 2018
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