Drug-induced depressive symptoms: An update through the WHO pharmacovigilance database

药物警戒 医学 药物流行病学 萧条(经济学) 产品特性概述 药品 优势比 精神科 抗精神病药 药理学 内科学 精神分裂症(面向对象编程) 药方 经济 宏观经济学
作者
Julien Li,Yoann Zelmat,Wilhelm Storck,Edouard‐Jules Laforgue,Antoine Yrondi,Alexander Balcerac,Agnès Sommet,François Montastruc
出处
期刊:Journal of Affective Disorders [Elsevier BV]
卷期号:350: 452-467 被引量:3
标识
DOI:10.1016/j.jad.2024.01.119
摘要

Depression is a highly incident condition and some drugs have been described as inducing or worsening depression. However, literature on this topic is rare and possibly outdated. We performed disproportionality analyses using VigiBase®, the largest pharmacovigilance database worldwide to identify drugs associated with depression. Then we excluded drugs already known as depressogenic according to American Summary of Product Characteristics (SPC). We then reviewed drug mechanism of action, scientific literature and European SPC for each drug identified to assess a level of plausibility. We measured Reporting Odds Ratio (ROR) statistically significant and superior to 1, suggesting a significant association between a drug and the reporting of depressive symptoms. Out of the 5237 drugs extracted on VigiBase®, we have retained 89 new drugs associated with depression. More than half of drugs of interest are from nervous system. Opicapone (ROR: 20.66 95 %CI: 15.62–27.33), and gadoversetamide (ROR 18.62, 95 %CI 9.63–35.95) were the drugs with the highest ROR. Among the 89 drugs, 38 were considered already described such as suvorexant or ivacaftor, 20 likely associated such as anti-migraines drugs or new antipsychotic drugs and 31 potentially associated. Pharmacovigilance studies have many inherent limitations, such as under-reporting bias, notoriety effect and protopathic bias. These results are not intended to establish a causal link, only a statistical association. We found a strong statistical signal and pharmacological plausibility for 58 new depressogenic drugs. This update list of suspected drugs may prove useful for doctors faced with potential cases of drug-induced depression or to stay aware in case. Other studies are needed to confirm the list.
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