Risk of Psychiatric Adverse Events Among Montelukast Users
| Autor: | Sengwee Toh, Efe Eworuke, Dinci Pennap, Noelle M. Cocoros, Andrew D. Mosholder, Elizabeth C. Dee, Veronica V. Sansing-Foster, Ella Pestine, Nicole Haug, Andrew B. Petrone, Ivone Kim, Yong Ma, Jennifer G. Lyons, Marie C. Bradley |
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| Rok vydání: | 2020 |
| Předmět: |
Cyclopropanes
medicine.medical_specialty Acetates Sulfides Lower risk 03 medical and health sciences 0302 clinical medicine Psychiatric history Immunology and Allergy Medicine Humans 030212 general & internal medicine Anti-Asthmatic Agents Adverse effect Psychiatry Child Depression (differential diagnoses) Montelukast Asthma business.industry Hazard ratio medicine.disease 030228 respiratory system Propensity score matching Quinolines Drug Therapy Combination business medicine.drug |
| Zdroj: | The journal of allergy and clinical immunology. In practice. 9(1) |
| ISSN: | 2213-2201 |
| Popis: | Background There have been conflicting results from observational studies regarding the risk of psychiatric adverse events (PAEs) with montelukast use. Objective To determine whether there are associations of depressive disorders, self-harm, and suicide with use of montelukast compared with inhaled corticosteroid (ICS) use. Methods Using data from the Sentinel Distributed Database from January 1, 2000, to September 30, 2015, patients (n = 457,377) exposed to montelukast or ICS, aged 6 years and older with a diagnosis of asthma, were matched 1:1 on propensity scores. Hazard ratios (HRs) and 95% CIs were estimated for each study outcome overall and by age, sex, psychiatric history, and pre-/post-2008 labeling updates using Cox proportional hazards regression models. Results Exposure to montelukast was associated with a lower risk of treated outpatient depressive disorder (HR, 0.91; 95% CI, 0.89-0.93). No increased risks of inpatient depressive disorder (HR, 1.06; 95% CI, 0.90-1.24), self-harm (HR, 0.92; 95% CI, 0.69-1.21), or self-harm using a modified algorithm (HR, 0.81; 95% CI, 0.63-1.05) were observed with montelukast use compared with ICS use. Most PAEs occurred in the roughly one-third of patients having a past psychiatric history. Conclusions When compared with use of ICS, we did not find associations between montelukast use and hospitalizations for depression or self-harm events. Our findings should be interpreted considering the study's limitations. Psychiatric comorbidity was common, and most PAEs occurred in patients with a past psychiatric history. |
| Databáze: | OpenAIRE |
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