Takeaway
- In patients with ulcerative colitis (UC), continuous use of serotonin selective reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) was associated with a significantly increased risk of corticosteroid dependency compared with non-use.
Why this matters
- Findings suggest that clinicians could consider antidepressant use as a predictor of potentially worse clinical outcomes in the natural history of UC.
Study design
- This population-based study included 6373 patients with incident UC with ≥3 years of follow-up, identified from the UK Clinical Practice Research Datalink (2005-2016).
- All patients were divided into 3 categories based on their use of SSRIs and TCAs in the 3 years following diagnosis: continuous users, intermittent users, and non-users.
- Funding: Living with IBD Research Programme at Crohn’s & Colitis UK.
Key results
- Overall, 5230 (82%) patients with UC had no prescription for either SSRIs or TCAs.
- Of 6373 patients with UC:
- 5464 (85.7%) were SSRI non-users, 627 (9.8%) were intermittent SSRI users and 282 (4.4%) were continuous SSRI users.
- 6064 (95.1%) were TCA non-users, 246 (3.9%) were intermittent TCA users and 63 (1%) were continuous TCA users.
- Intermittent SSRI users (adjusted OR [aOR], 1.19; 95% CI, 0.95-1.50) and TCA users (aOR, 1.14; 95% CI, 0.78-1.66) vs non-users had similar risks of corticosteroid dependency.
- Continuous SSRI users (aOR, 1.62; 95% CI, 1.15-2.27) and TCA users (aOR, 2.02; 95% CI, 1.07-3.81) vs non-users had a significantly increased risk of corticosteroid dependency.
Limitations
- Corticosteroid prescriptions in secondary care were not included.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
