Montelukast and risk for antidepressant treatment failure.

Autor: Chung H; Department of Pharmacy, Iowa City Veterans Affairs Health Care System, Iowa City, IA, United States of America., Hanken K; Department of Pharmacy, Iowa City Veterans Affairs Health Care System, Iowa City, IA, United States of America., Gerke AK; Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, United States of America., Lund BC; Center for Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, IA, United States of America; Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, United States of America. Electronic address: Brian.Lund@va.gov.
Jazyk: angličtina
Zdroj: Journal of psychosomatic research [J Psychosom Res] 2023 Jan; Vol. 164, pp. 111075. Date of Electronic Publication: 2022 Nov 09.
DOI: 10.1016/j.jpsychores.2022.111075
Abstrakt: Objective: While implicated in causing depression, no studies have examined the impact of montelukast on antidepressant effectiveness. We examined whether existing montelukast therapy was associated with acute antidepressant treatment failure (objective 1), and whether montelukast initiation was associated with depression relapse during maintenance antidepressant therapy (objective 2), relative to inhaled corticosteroid (ICS).
Methods: Patients with asthma and depression were identified using national Veterans Health Administration data from 2007 to 2019. Objective 1: 12,109 patients initiated an antidepressant after receiving montelukast or ICS for 6 months. The primary outcome was acute antidepressant treatment failure, defined as subsequent initiation of a new antidepressant or augmenting agent within 6 months. Objective 2: 14,673 patients initiated montelukast or ICS after receiving stable antidepressant monotherapy for 6 months. The primary outcome of depression relapse was defined by a subsequent change in the pre-existing maintenance antidepressant regimen within 6 months. Both objectives employed a retrospective cohort design with log-binomial regression.
Results: Objective 1: Acute antidepressant failure was observed in 21.3% (628/2943) and 22.3% (2044/9166) of patients receiving montelukast versus ICS, respectively. Relative risk in adjusted analyses was 0.98 (95% CI: 0.90, 1.07). Objective 2: Depression relapse was observed in 24.4% (288/1182) and 22.4% (3027/13,491) of patients initiating montelukast versus ICS, respectively. Relative risk in adjusted analyses was 1.08 (95% CI: 0.96, 1.20) within 6 months and 1.50 (95% CI: 1.16, 1.93) within 45 days.
Conclusion: Discontinuation of existing montelukast therapy is unnecessary when initiating antidepressants. However, potential evidence for depression relapse following montelukast initiation warrants additional investigation.
Competing Interests: Declaration of Competing Interest The authors have no competing interests to report.
(Published by Elsevier Inc.)
Databáze: MEDLINE
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