Association between antidepressant use and prescribing of gastric acid suppressants.
OBJECTIVE
To determine whether an increased risk of gastrointestinal events is present in younger, generally healthy adults who consume antidepressants.


METHODS
We performed a retrospective cohort study using the pharmacy records of Canadian Forces (CF) members who received antidepressants between June 1997 and November 2002, excluding those taking bupropion for smoking cessation. The control cohort comprised members who received salbutamol. Changes in use of gastric acid-reducing agents (GARs) and incident GAR prescribing rates were compared pre- and postinitiation of target medications. We performed ogistic regression analyses to evaluate the effects of age, sex, and concomitant medication use on GAR prescribing.


RESULTS
A total of 8722 antidepressant exposures were identified among 5588 CF members. The control cohort consisted of 3059 people with 4154 salbutamol exposures. The number of incident GAR prescriptions decreased in both groups postexposure; however, the rate of decrease was significantly greater among salbutamol users (odds ratio 1.38; 95%CI, 1.12 to 1.71). Antidepressant users were significantly more likely to receive a new prescription for GAR following both short-term and long-term exposure (adjusted odds ratio 4.93; 95%CI, 2.66 to 9.21 and 2.83; 95%CI, 2.05 to 3.92, respectively). Antiplatelet agents, bisphosphonates, oral corticosteroids, and nonsteroidal antiinflammatory drugs were significant predictors of GAR prescription.


CONCLUSIONS
Consistent with other reports, this study has identified that antidepressant use increases the risk for use of a gastric acid suppressant. Careful consideration should thus be made with regard to increased gastric event risk among antidepressant users.
Ma
Janice
J
Canadian Forces Health Services, Ottawa, Ontario. ma.j@forces.gc.ca
Vaillancourt
Régis
R
Boddam
Randy
R
Auger
Stéphane
S
Sampalis
John
J
D000328:Adult; D000420:Albuterol / Q000009:adverse effects; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000145:classification; D001993:Bronchodilator Agents / Q000009:adverse effects; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004358:Drug Therapy / Q000706:statistics & numerical data; D005260:Female; D005744:Gastric Acid / Q000378:metabolism; D006801:Humans; D016015:Logistic Models; D008297:Male; D010437:Peptic Ulcer / Q000139:chemically induced* / Q000188:drug therapy* / Q000378:metabolism; D012189:Retrospective Studies
D000897:Anti-Ulcer Agents; D000928:Antidepressive Agents; D001993:Bronchodilator Agents; D000420:Albuterol