Observed association between antidepressant use and pneumonia risk was confounded by comorbidity measures.
OBJECTIVE
A prior study suggested that antidepressants might increase the risk of hospitalization for pneumonia in the elderly. This study sought to confirm or refute this hypothesis.


METHODS
Case-control study of persons aged 65 and above nested in the UK General Practice Research Database.


RESULTS
We identified 12,044 cases of the hospitalization for pneumonia (the primary outcome) and 48,176 controls. The odds ratio (OR) for any antidepressant use, adjusting for age, sex, and calendar year was 1.61 (95% confidence interval 1.46-1.78). After further adjustment for comorbidity measures, the OR was 0.89 (0.79-1.00). We also identified 159 cases of hospitalization for aspiration pneumonia (the secondary outcome) and 636 controls. The OR for any antidepressant use, adjusted for age, sex, and calendar year was 1.45 (0.65-3.24). After further adjustment for comorbidity measures, the OR was 0.63 (0.23-1.71).


CONCLUSIONS
These findings refute the prior hypothesis that use of antidepressants by elderly patients increases the risk of hospitalization for pneumonia or for aspiration pneumonia. Decisions regarding use of antidepressants in elderly persons should not be affected by concern about pneumonia risk. Data-derived hypotheses should be independently confirmed before being acted upon.
Hennessy
Sean
S
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. shenness@cceb.med.upenn.edu
Bilker
Warren B
WB
Leonard
Charles E
CE
Chittams
Jesse
J
Palumbo
Cristin M
CM
Karlawish
Jason H
JH
Yang
Yu-Xiao
YX
Lautenbach
Ebbing
E
Baine
William B
WB
Metlay
Joshua P
JP
D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D016017:Odds Ratio; D011014:Pneumonia / Q000453:epidemiology* / Q000523:psychology; D018570:Risk Assessment / Q000379:methods; D012737:Sex Factors; D006113:United Kingdom
D000928:Antidepressive Agents
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