Depression and treatment with antidepressants are associated with the development of gastro-oesophageal reflux disease.
BACKGROUND
The roles of depression and antidepressants in triggering reflux symptoms remain unclear.


OBJECTIVE
To compare the incidence of gastro-oesophageal reflux disease (GERD) in individuals with and without a depression diagnosis and to evaluate risk factors for a GERD diagnosis. The relationship between antidepressant treatment and GERD was also assessed.


METHODS
The Health Improvement Network UK primary care database was used to identify patients with incident depression and an age- and sex-matched control cohort with no depression diagnosis. Incident GERD diagnoses were identified during a mean follow-up of 3.3 years. Furthermore, we performed nested case-control analyses where odds ratios (OR) with 95% confidence intervals (CI) were estimated by unconditional logistic regression in multivariable models.


RESULTS
The incidence of GERD was 14.2 per 1000 person-years in the depression cohort and 8.3 per 1000 person-years in the control cohort. The hazard ratio of GERD in patients with depression compared with controls was 1.72 (95% CI: 1.60-1.85). Among patients with depression, tricyclic antidepressant use was associated with an increased risk of GERD (OR: 1.71; 95% CI: 1.34-2.20), while selective serotonin reuptake inhibitors were not associated with GERD.


CONCLUSIONS
A depression diagnosis is associated with an increased risk of a subsequent GERD diagnosis, particularly in individuals using tricyclic antidepressants.
Martín-Merino
E
E
Spanish Centre for Pharmacoepidemiologic Research, Madrid, Spain. elisaceife@telefonica.net <elisaceife@telefonica.net>
Ruigómez
A
A
García Rodríguez
L A
LA
Wallander
M-A
MA
Johansson
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects*; D002648:Child; D003866:Depressive Disorder / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
D000928:Antidepressive Agents