| アブストラクト | BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) have been associated with type 2 diabetes mellitus (T2DM) in youths, possibly via 5-HT(2C), H(1) receptors and serotonin transporter (SERT). SSRIs have similar affinity for SERT but variable affinity for 5-HT(2C) and H(1). This study assessed whether SSRIs with strong affinity for 5-HT(2C) and H(1) (relative to SERT) were associated with T2DM risk compared with weak-affinity SSRIs. METHODS: Using the UK Clinical Practice Research Datalink, we assembled a cohort of patients aged 5-24, newly prescribed a strong-affinity SSRI (citalopram, escitalopram, fluoxetine) or weak affinity (paroxetine, sertraline, fluvoxamine) between 1990 and 2019. We controlled for confounding using standardized mortality ratio weighting, estimated from calendar time-specific propensity scores. We used weighted Cox proportional hazards models to estimate hazard ratios (HRs) of incident T2DM with 95 % confidence intervals (CIs). RESULTS: The cohort included 347,368 new users of strong-affinity SSRIs and 131,359 of weak-affinity SSRIs. Strong-affinity SSRIs were not associated with an increased T2DM risk compared with weak-affinity SSRIs (incidence rate 2.8 vs 2.7 per 1000 person-years; HR 1.03, 95 % CI 0.85-1.25). T2DM risk did not vary with duration of use, age or sex. However, the HR was numerically higher in youths with normal or low weight (HR 1.30, 95 % CI 0.85-1.98) and with prior antipsychotic use (HR 1.62, 95 % CI 0.83-3.18). LIMITATIONS: Median duration of SSRI use, in line with real-world SSRI prescribing, was relatively short. CONCLUSION: T2DM risk did not differ between strong- and weak-affinity SSRIs, providing reassurance for clinicians when choosing between SSRIs in youths. |
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| 投稿者 | Cao, Thi Xuan Dai; Filliter, Christopher; Montastruc, Francois; Yu, Oriana Hoi Yun; Fergusson, Emma; Rej, Soham; Azoulay, Laurent; Renoux, Christel |
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| 組織名 | Department of Epidemiology, Biostatistics, and Occupational Health, McGill;University, Montreal, Quebec, Canada; Centre for Clinical Epidemiology, Lady;Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.;Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital,;Montreal, Quebec, Canada.;Department of Clinical and Medical Pharmacology, Regional Pharmacovigilance;Centre, Faculty of Medicine and Toulouse University Hospital, Toulouse, France.;Montreal, Quebec, Canada; Division of Endocrinology, Jewish General Hospital,;Oxford Health NHS Trust, Department of Psychiatry, Oxford University, Oxford,;United Kingdom.;Department of Psychiatry, McGill University, Montreal, Quebec, Canada.;Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada; Gerald;Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada.;Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada; Department of;Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.;Electronic address: christel.renoux@mcgill.ca. |
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