| アブストラクト | Background: Depression, a major global health issue, is commonly treated with selective serotonin reuptake inhibitors (SSRIs). Given the link between depression and inflammation, nonsteroidal anti-inflammatory drugs (NSAIDs) may have adjunctive benefits. Clinically, SSRIs and NSAIDs are often co-prescribed for comorbid pain or inflammatory conditions. However, both drug classes pose risks of adverse effects, and their interaction may lead to clinically significant drug-drug interactions. Objectives: This study analyzed FDA Adverse Event Reporting System (FAERS) data (2004-2024) to assess gastrointestinal bleeding, thrombocytopenia, and acute kidney injury (AKI) potential risks linked to SSRIs (citalopram, escitalopram, fluoxetine, paroxetine, fluvoxamine, and sertraline) and NSAIDs (propionic/acetic/enolic acid derivatives, COX-2 inhibitors) in depression patients, alone and combined. Methods: Disproportionality analysis (crude reporting odds ratios, cROR) identified possible associations; drug interactions were evaluated using Omega shrinkage, additive, multiplicative, and combination risk ratio (CRR) models. Results: Gastrointestinal bleeding risk was potentially elevated with citalopram (cROR = 2.81), escitalopram (2.27), paroxetine (2.17), fluvoxamine (3.58), sertraline (1.69), and propionic acid NSAIDs (3.17). Thrombocytopenia showed a potential correlation with fluoxetine (2.11) and paroxetine (2.68). AKI risk may be increased with citalopram (1.39), escitalopram (1.36), fluvoxamine (3.24), and COX-2 inhibitors (2.24). DDI signal analysis suggested that citalopram in combination with propionic acid derivatives (additive model = 0.01, multiplicative model = 1.14, and CRR = 3.13) might increase the risk of bleeding. Paroxetine combined with NSAIDs (additive model = 0.014, multiplicative model = 2.65, and CRR = 2.99) could potentially increase the risk of thrombocytopenia. Sertraline combined with NSAIDs (Omega(025) = 0.94, multiplicative model = 2.14) might be associated with an increasing risk of AKI. Citalopram combined with propionic acid derivatives (Omega(025) = 1.08, multiplicative model = 2.17, and CRR = 2.42) could be associated with an increased risk of acute kidney injury. Conclusions: Certain combinations of SSRIs and NSAIDs might further elevate these risks of gastrointestinal bleeding, thrombocytopenia, and acute kidney injury in patients with depression. Given the potential drug-drug interactions, heightened clinical vigilance is advised when prescribing SSRIs and NSAIDs in combination to patients with depression. |
|---|
| 投稿者 | Zhang, Yi; Liu, Xiaoyu; Wu, Jianru; Zhang, Xuening; Wei, Fenfang; Li, Limin; Li, Hongqiao; Wang, Xinru; Wang, Bei; Wu, Wenyu; Hong, Xiang |
|---|
| 組織名 | Key Laboratory of Environmental Medicine and Engineering of Ministry of;Education, School of Public Health, Southeast University, Nanjing 210009, China.;Shenzhen Institute of Pharmacovigilance and Risk Management, Shenzhen 518024,;China.;Jiangsu Health Development Research Center, Nanjing 210029, China.;NHC Key Laboratory of Contraceptives Vigilance and Fertility Surveillance,;Nanjing 210029, China.;Jiangsu Provincial Medical Key Laboratory of Fertility Protection and Health;Technology Assessment, Nanjing 210029, China. |
|---|
