title: Association between antipsychotic drug use and cataracts in patients with bipolar disorder: A population-based, nested case-control study.
abstract: No previous study has focused on the association between use of antipsychotic drugs and the development of cataracts in patients with bipolar disorder (BD); hence, we aimed to examine this association in the present study.
  
  
  
  We conducted a retrospective nested case-control study using data from the National Health Insurance Database of Taiwan between 2000 and 2011. A total of 3292 BD patients, 1684 with cataracts and 1608 controls matched for age, sex, and index date, were included. Antipsychotic drug exposure was categorized by type of drug and duration of use. A conditional logistic regression analysis was used to analyze the association.
  
  
  
  Among BD patients, we found significantly reduced odds ratio (OR) of cataract development among past (adjusted OR (AOR), 0.74; 95% confidence interval (CI), 0.62-0.89; p=0.001) and continuous users (AOR, 0.71; 95% CI, 0.59-0.85; p<0.001) of atypical antipsychotics. No association was found between the odds of cataract development and typical antipsychotics. Besides, concomitant use of antidepressants (AOR, 1.23; 95% CI, 1.06-1.43; p=0.007) and mood stabilizers (AOR, 1.23; 95% CI, 1.06-1.42; p=0.007) were associated with increased odds of cataract development.
  
  
  
  Some important contributors to cataract development such as family history of cataract, smoking and alcohol exposure could not be measured from the claims data and this may confound the results.
  
  
  
  Reduced odds of cataract were found in patients with BD taking atypical antipsychotics. However, given that BD patients often have risk factors for developing cataract, regular ocular evaluations are recommended for those treated with antipsychotics drugs.
authors.affiliation: Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Che-Sheng
authors.initials: CS
authors.lastname: Chu
authors.affiliation: Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang Ming University, Taipei, Taiwan; Department of Photonics, National Chiao Tung University, Hsinchu, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan. Electronic address: phchou1980@gmail.com.
authors.forename: Po-Han
authors.initials: PH
authors.lastname: Chou
authors.affiliation: Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Yi-Huei
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Chia-Yi branch, Taichung Veterans General Hospital, Chiayi City, Taiwan.
authors.forename: Min-Wei
authors.initials: MW
authors.lastname: Huang
authors.affiliation: Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Min-Yen
authors.initials: MY
authors.lastname: Hsu
authors.affiliation: Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Tsuo-Hung
authors.initials: TH
authors.lastname: Lan
authors.affiliation: Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan. Electronic address: lonelymanym@yahoo.com.tw.
authors.forename: Ching-Heng
authors.initials: CH
authors.lastname: Lin
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology*; D016022:Case-Control Studies; D002386:Cataract / Q000453:epidemiology* / Q000517:prevention & control; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents
keywords: Antidepressant; Antipsychotic; Bipolar disorder; Cataract; Mood stabilizer