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SEROTONERGIC ANTIDEPRESSANT USE AND MORBIDITY AND MORTALITY AMONG OLDER ADULTS WITH COPD

Nicholas T Vozoris, Xuesong Wang, Peter C Austin, Anne L Stephenson, Denis E O'Donnell, Andrea S Gershon, Sudeep S Gill, Paula A Rochon
European Respiratory Journal 2018; DOI: 10.1183/13993003.00475-2018
Nicholas T Vozoris
aDivision of Respirology, Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
bKeenan Research Centre in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
cDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada
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Xuesong Wang
dInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
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Peter C Austin
dInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
eInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Anne L Stephenson
aDivision of Respirology, Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
bKeenan Research Centre in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
cDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada
eInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Denis E O'Donnell
fDepartment of Medicine, Queen's University, Kingston, Ontario, Canada
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Andrea S Gershon
cDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada
dInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
eInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
gSunnybrook Hospital, Department of Medicine, Toronto, Ontario, Canada
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Sudeep S Gill
dInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
fDepartment of Medicine, Queen's University, Kingston, Ontario, Canada
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Paula A Rochon
cDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada
dInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
eInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
hWomen's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
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Abstract

We evaluated the relationship between new selective serotonin reuptake inhibitor (SSRI) or serotonin norepinephrine reuptake inhibitor (SNRI) drug use and respiratory-related morbidity and mortality among older adults with chronic obstructive pulmonary disease (COPD).

This was retrospective, population-based, cohort study using Ontario, Canada, heath administrative data. Individuals ages 66 years of age and older, 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 minimize potential confounding.

Among propensity-scored matched community-dwelling individuals, new SSRI/SNRI users compared to non-users had significantly higher rates of hospitalization for COPD or pneumonia (hazard ratio [HR] 1.15; 95% confidence interval [CI] 1.05–1.25), ER 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). Respiratory-specific and all-cause mortality rates were also 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.

Footnotes

This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Vozoris has nothing to disclose.

Conflict of interest: Xuesong Wang has nothing to disclose.

Conflict of interest: Dr. Austin has nothing to disclose.

Conflict of interest: Dr. Stephenson has nothing to disclose.

Conflict of interest: Dr. O'Donnell reports grants and personal fees from Boehringer Ingelheim, grants and personal fees from Astra Zeneca, grants and personal fees from GlaxoSmithKline, personal fees from Novartis, personal fees from Pfizer, personal fees from Almirall, outside the submitted work; .

Conflict of interest: Dr. Gershon has nothing to disclose.

Conflict of interest: Dr. Gill has nothing to disclose.

Conflict of interest: Dr. Rochon has nothing to disclose.

This is a PDF-only article. Please click on the PDF link above to read it.

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SEROTONERGIC ANTIDEPRESSANT USE AND MORBIDITY AND MORTALITY AMONG OLDER ADULTS WITH COPD
Nicholas T Vozoris, Xuesong Wang, Peter C Austin, Anne L Stephenson, Denis E O'Donnell, Andrea S Gershon, Sudeep S Gill, Paula A Rochon
European Respiratory Journal Jan 2018, 1800475; DOI: 10.1183/13993003.00475-2018

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SEROTONERGIC ANTIDEPRESSANT USE AND MORBIDITY AND MORTALITY AMONG OLDER ADULTS WITH COPD
Nicholas T Vozoris, Xuesong Wang, Peter C Austin, Anne L Stephenson, Denis E O'Donnell, Andrea S Gershon, Sudeep S Gill, Paula A Rochon
European Respiratory Journal Jan 2018, 1800475; DOI: 10.1183/13993003.00475-2018
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