1
|
The Association between Use of Benzodiazepine Receptor Agonists and the Risk of Obstructive Sleep Apnea: A Nationwide Population-Based Nested Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189720. [PMID: 34574645 PMCID: PMC8467455 DOI: 10.3390/ijerph18189720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022]
Abstract
Obstructive sleep apnea (OSA) is characterized by recurrent upper airway collapse. Benzodiazepine receptor agonists (BZRAs) are associated with pharyngeal muscle relaxation, increased apnea duration, and hypoxia, which might worsen OSA. This study aimed to examine the association between the use of BZRAs and the risk of OSA. The study was conducted using data from the National Health Insurance Database of Taiwan between 2002 and 2011. We only included new users who were never exposed to any BZRAs and identified 1848 participants with OSA, and 1848 matched controls. A logistic regression model was used to determine the association between the use of BZRAs and the development of OSA. BZRA exposure was divided into usage patterns, dosage, duration, and pharmacokinetic class. We found an increased risk of OSA in current users and recent past users compared with distant past users. Patients with a higher cumulative dose of BZRAs were more likely to develop OSA compared to those with a lower cumulative dose. We found an increased risk of OSA in patients treated with BZRAs, especially for current users and those with higher cumulative doses. A reduced risk of OSA was found in Z-drug users compared with benzodiazepine users.
Collapse
|
2
|
Kuo CM, Liao WJ, Huang CC, Lan TH, Lin CH, Wang SP, Lee CH, Lui PW. Antipsychotic Medication in Schizophrenic Patients is Associated with Higher Risks of Developing Bone Fractures and Refractures. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2020; 18:562-570. [PMID: 33124588 PMCID: PMC7609221 DOI: 10.9758/cpn.2020.18.4.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/20/2020] [Accepted: 05/27/2020] [Indexed: 11/21/2022]
Abstract
Objective The relationship of antipsychotics and the risk of refracture in treated patients is unclear. The aim of this study is to evaluate the association between prolonged antipsychotic and the incidences of bone fractures and refractures in schizophrenia. Methods This is a retrospective nested case-control study using Taiwan National Health Insurance Research Database recorded from 2000 to 2005, with cases followed up to end of 2011. Total of 7,842 schizophrenic patients, 3,955 had developed bone fractures were compared with 3,887 control subjects matched in age, sex, and index date. Antipsychotic drug exposure was classified based on the drug type and medication duration. Conditional logistic regression analyses were performed. Odds ratio (OR) and confidence interval (CI) were calculated. Results We found (after adjustments) higher risks of developing fractures under continued use of typical (OR = 1.70; 95% CI, 1.51−1.91) or atypical antipsychotics (OR = 1.43; 95% CI, 1.28−1.60) were found. Additionally, continued use typical (OR = 1.84; 95% CI, 1.35−2.50) or atypical antipsychotics (OR = 1.44; 95% CI, 1.06−1.95) was positively associated with refracture risks. Moreover, refractures were associated with continuous use of chlorpromazine (one typical antipsychotics, OR = 2.45; 95% CI, 1.14−5.25), and risperidone (OR = 1.48; 95% CI, 1.01−2.16) or zotepine (OR = 2.15; 95% CI, 1.06−4.36) (two atypical antipsychotics). Conclusion Higher risks of bone fracture and refracture were found in schizophrenia under prolonged medication with typical or atypical antipsychotics. We therefore recommend that clinicians should pay more attention on bone density monitoring for patients using long-term antipsychotics.
Collapse
Affiliation(s)
- Ching-Min Kuo
- Departments of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Wei-Jen Liao
- Departments of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chun-Che Huang
- Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan.,Health Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tsuo-Hung Lan
- Departments of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.,Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
| | - Ching-Heng Lin
- Health Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shun-Ping Wang
- Departments of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan.,Sports Recreation and Management Continuing Studies-Bachelor's Degree Completion Program, Tunghai University, Taichung, Taiwan
| | - Cheng-Hung Lee
- Departments of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ping-Wing Lui
- Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan.,Office of Superintendent, Saint Paul Hospital, Taoyuan, Taiwan
| |
Collapse
|
3
|
Fang SC, Huang CY, Liao DL, Hsu CC, Shao YHJ. Associations among antipsychotics, metabolism-related diseases, and cataracts in patients with schizophrenia: A retrospective cohort study. Schizophr Res 2019; 212:150-156. [PMID: 31395489 DOI: 10.1016/j.schres.2019.07.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/04/2019] [Accepted: 07/28/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Long-term cataract risks associated with first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs), and their associations with metabolism-related diseases are not yet elucidated. METHODS Using Taiwan National Health Insurance data, we conducted a propensity score matched population-based cohort study consisting of 10,014 patients with newly diagnosed schizophrenia from 2005 to 2009 and followed them until the end of 2013. A Cox hazard model with metabolism-related diseases as time-dependent covariates was adapted to estimate the hazard ratio (HR) of cataracts between SGAs and FGAs groups. RESULTS During the 8-year follow-up, patients receiving SGAs were associated with a higher risk of cataract than those receiving FGAs with an adjusted HR of 1.59 (95% confidence interval [CI] = 1.06-2.36). Patients receiving high-metabolic-risk SGAs (clozapine and olanzapine) showed the highest risk of cataracts among SGAs when compared with those receiving FGAs (aHR = 2.57, 95% CI: 1.35-4.88). SGAs demonstrated a stronger contribution in the risk of cataract in patients without diabetes mellitus (DM) and hyperlipidemia than in those developed these diseases. Patients who developed DM or hyperlipidemia after receiving antipsychotics had an approximately 2.5-fold increased cataract risk over those who did not develop these diseases. CONCLUSIONS Regardless of the condition of metabolic-related diseases, SGAs were independently associated with an increased risk of cataract. DM and hyperlipidemia developed after antipsychotics contributed to the risk of cataract risk.
Collapse
Affiliation(s)
- Su-Chen Fang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Yi Huang
- Department of Community Psychiatry and Addiction Psychiatry, Bali Psychiatric Center, New Taipei City, Taiwan
| | - Ding-Lieh Liao
- Department of General Psychiatry, Taoyuan Psychiatric Center, Taoyuan, Taiwan
| | - Chun-Chi Hsu
- Department of General Psychiatry, Taoyuan Psychiatric Center, Taoyuan, Taiwan
| | - Yu-Hsuan Joni Shao
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan; Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA; Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
| |
Collapse
|
4
|
Chong LW, Hsu CC, Lee CY, Chou RH, Lin CL, Chang KH, Hsu YC. Association of viral hepatitis and bipolar disorder: a nationwide population-based study. J Transl Med 2018; 16:173. [PMID: 29929549 PMCID: PMC6013873 DOI: 10.1186/s12967-018-1542-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 06/07/2018] [Indexed: 12/14/2022] Open
Abstract
Background Bipolar disorder (BD), a type of psychiatric mood disorder, is manifested by chronic and recurrent mood fluctuations. This study aims to determine whether hepatitis B virus (HBV) or hepatitis C virus (HCV) infection is a risk factor for BD. Methods A total of 48,215 patients with newly diagnosed viral hepatitis from 2000 to 2010 were identified and frequency-matched with 192,860 people without hepatitis. Both groups were followed until diagnosis with BD, withdrawal from the national health insurance program, or the end of 2011. Patients with viral hepatitis were grouped into 3 cohorts: HBV infection, HCV infection, and HBV/HCV coinfection. The association between viral hepatitis and BD were examined using Cox proportional hazards regression models. Results The incidence of BD was higher in HBV/HCV coinfection than in the control group, with an adjusted hazard ratio of 2.16 (95% confidence interval 1.06–4.41) when adjusted for sex, age, and comorbidity. After further adjustment, we noted that an age more than 65 years and female may be associated with an increased risk of BD in patients with chronic hepatitis B and C. Conclusion Viral hepatitis may be associated with increased risk of subsequent BD. Electronic supplementary material The online version of this article (10.1186/s12967-018-1542-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Lee-Won Chong
- Division of Hepatology and Gastroenterology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Chih-Chao Hsu
- Division of Psychiatry, Taitung Branch, Taipei Veterans General Hospital, Taitung, Taiwan
| | - Chang-Yin Lee
- College of Medicine, The School of Chinese Medicine for Post Baccalaureate, I-Shou University (Yancho Campus), Kaohsiung, Taiwan.,Department of Chinese Medicine, E-DA Hospital, Kaohsiung, Taiwan.,Department of Chinese Medicine, E-DA Cancer Hospital, Kaohsiung, Taiwan
| | - Ruey-Hwang Chou
- Graduate Institute of Biomedical Sciences and Center for Molecular Medicine, China Medical University, Taichung, Taiwan.,Department of Biotechnology, Asia University, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Kuang-Hsi Chang
- Department of Medical Research, Tungs' Taichung Metroharbor Hospital, Taichung, Taiwan. .,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.
| | - Yi-Chao Hsu
- Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan.
| |
Collapse
|
5
|
Chu CS, Lin CH, Lan TH, Chou PH. Associations between use of mood stabilizers and risk of cataract: A population-based nested case-control study. J Affect Disord 2018; 227:79-81. [PMID: 29053979 DOI: 10.1016/j.jad.2017.10.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 08/23/2017] [Accepted: 10/04/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of this study was to investigate whether use of mood stabilizers (MS) is associated with an increased risk of cataract development. METHODS We conducted a nested case-control study using National Health Insurance Research Database in Taiwan. A total of 14,288 patients with bipolar disorder (BD) and schizophrenia were included; 7651 in the cataract group and 6637 in the control group. Based on overall cumulative period of MS (lithium, carbamazepine, valproate, and lamotrigine) treatment, we categorized into following groups: no use, and duration < 1 year, 1 to 2 years, and > 2 years. Conditional logistic regression analysis was used to explore the association between use of MS and risk of cataract development. RESULTS The risks for cataract development were significantly higher in patients using lithium alone and lithium combined with other MS for more than 2 years (adjusted odd ratio [AOR] = 1.39; 95% CI = 1.01-1.92, p = 0.043 and AOR = 1.44; 95% CI = 1.13-1.85, p = 0.003, respectively) than in non-users. Furthermore, the risks of cataract development increased in those treated with valproic acid combined with other MS (AOR = 1.26; 95% CI = 1.02-1.57, p = 0.035). Finally, no increased risks of cataract development were found in carbamazepine and lamotrigine users. CONCLUSIONS We found increased risks of cataract development in long-term users of lithium, lithium combined with other MS and valproic acid combined with other MS for more than two years among patients with BD and schizophrenia.
Collapse
Affiliation(s)
- Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ching-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tsuo-Hung Lan
- Department of Psychiatry, Faculty of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Po-Han Chou
- Department of Psychiatry, Faculty of Medicine, National Yang Ming University, Taipei, Taiwan; Department of Photonics, National Chiao Tung University, Hsinchu, Taiwan; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA.
| |
Collapse
|
6
|
Antidepressants and risk of cataract development: A population-based, nested case-control study. J Affect Disord 2017; 215:237-244. [PMID: 28342338 DOI: 10.1016/j.jad.2017.03.044] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/13/2017] [Accepted: 03/17/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Previous studies demonstrated increased risk of cataract development among users of selective serotonin reuptake inhibitors (SSRIs). However, it remains unknown whether this risk also prevails with the use of other types of antidepressants. The aim of this study was to investigate whether use of antidepressants is associated with an increased risk of cataract development. Moreover, the relationship between binding affinities of serotonin transporter (SERT) of antidepressant and the risk of cataracts is examined. METHODS We conducted a nested case-control study using National Health Insurance Research Database in Taiwan. A total of 14,288 patients were included; 7651 in the cataract group and 6637 in the control group. Antidepressant exposure was categorized by type, duration of use, and binding affinities of SERT. The association between antidepressant exposure and cataract development was assessed using conditional logistic regression analysis. RESULTS The adjusted odds ratios (AORs) for developing cataracts among continuous users of SSRIs, serotonin norepinephrine reuptake inhibitors (SNRIs), and other antidepressants were 1.26 (95% confidence interval (CI): 1.12-1.41, p<0.001), 1.21 (95% CI: 1.02-1.43, p=0.027), and 1.18 (95% CI: 1.04-1.34, p=0.009) respectively. Specifically, continuous uses of fluoxetine (AOR: 1.21; 95% CI: 1.01-1.46, p=0.042), fluvoxamine (AOR: 1.47; 95% CI: 1.01-2.12, p=0.043), venlafaxine (AOR: 1.44; 95% CI: 1.19-1.74, p<0.001) significantly increased the risk of cataract development. Moreover, continuous users of antidepressants with intermediate SERT binding affinities (AOR: 1.68; 95% CI: 1.10-2.56, p=0.017) were significantly associated with increased risks of cataract development. LIMITATIONS Several confounding factors such as obesity, multiple drug users, family history of cataracts, substance use, and environmental factors (such as sunlight or radiation exposure) were acquired. CONCLUSIONS We found increased risk of cataract development in patients continuously using antidepressants. Regular ocular evaluations in these patients are warranted.
Collapse
|