| アブストラクト | BACKGROUND: Although antidepressants have been implicated in seizure risk, comprehensive safety data examining this risk across different antidepressants remains limited. METHODS: Data from Vigibase, an international pharmacovigilance database, encompassing 131,255,418 reports from 1967 to 2023, was analyzed. Reporting odds ratio (ROR) and information component (IC) were calculates to identify disproportionate associations between 17 antidepressants and seizures. RESULTS: Among 2,275,638 reports on antidepressants, 23,331 reported seizures. Antidepressants as a whole were associated with higher reporting frequency of seizures compared with all medications. Among antidepressant classes, tricyclic antidepressants (TCA; ROR [95 % CI]: 2.71 [2.58-2.84]; IC [IC0.25] 1.42 [1.34]), were the most frequently reported in combination with seizures, followed by selective serotonin reuptake inhibitors (SSRIs; 2.27 [2.22-2.32]; 1.16 [1.13]) and serotonin-norepinephrine reuptake inhibitors (SNRIs; 1.31 [1.27-1.36]; 0.39 [0.33]). Regarding individual antidepressants, agomelatine and desvenlafaxine were the only medications without a significant disproportionate association with seizures. Among the remaining antidepressants, bupropion (8.57 [8.34-8.80]; 3.04 [3.00]) and clomipramine (4.69 [4.29-5.13]; 2.20 [2.05]) had the highest disproportionality measure estimates, whereas vortioxetine and duloxetine had the lowest disproportionality in reporting. Escitalopram (2.17 [2.04-2.31]; 1.11 [1.01]), the active enantiomer of citalopram, and desvenlafaxine (0.93 [0.82-1.05]; -0.11 [-0.31]), the active metabolite of venlafaxine, were less frequently reported for seizures compared to their parent compounds. CONCLUSION: Our findings align with earlier studies indicating that SNRIs and SSRIs carry a lower risk of seizures, whereas bupropion and clomipramine are linked to a higher risk. Agomelatine, vortioxetine, and SNRIs like desvenlafaxine and duloxetine may potentially be safe alternatives. |
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| 投稿者 | Cho, Hanseul; Lee, Kyeongmin; Wang, Sheng-Min; Lee, Hayeon; Kim, Soeun; Kim, Tae Hyeon; Fond, Guillaume; Boyer, Laurent; Jacob, Louis; Woo, Selin; Choi, Suein; Yon, Dong Keon |
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| 組織名 | Department of Medicine, Kyung Hee University College of Medicine, Seoul, South;Korea; Center for Digital Health, Medical Science Research Institute, Kyung Hee;University Medical Center, Kyung Hee University College of Medicine, Seoul, South;Korea.;Center for Digital Health, Medical Science Research Institute, Kyung Hee;Korea; Department of Regulatory Science, Kyung Hee University, Seoul, South;Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The;Catholic University of Korea, Seoul, South Korea.;Korea; Department of Electronics and Information Convergence Engineering, Kyung;Hee University, Yongin, South Korea.;Korea; Department of Precision Medicine, Kyung Hee University College of;Medicine, Seoul, South Korea.;CEReSS-Health Service Research and Quality of Life Center, Assistance;Publique-Hopitaux de Marseille, Aix Marseille University, Marseille, France.;Research and Development Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, ISCIII,;Barcelona, Spain; Department of Physical Medicine and Rehabilitation,;Lariboisiere-Fernand Widal Hospital, AP-HP, Universite Paris Cite, Paris, France;;Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Inserm U1153,;Universite Paris Cite, Paris, France.;Korea. Electronic address: dntpfls@naver.com.;Department of Pharmacology, College of Medicine, The Catholic University of;Korea, Seoul, South Korea; Pharmacometrics Institute for Practical Education and;Training (PIPET), College of Medicine, The Catholic University of Korea, Seoul,;South Korea. Electronic address: mychloe00@gmail.com.;Hee University, Yongin, South Korea; Department of Pediatrics, Kyung Hee;Korea. Electronic address: yonkkang@gmail.com. |
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