Antidepressants increase mortality risk in COPD by 20 percent

Patients with Chronic obstructive pulmonary disease(COPD)are at 20 percent increased risk of death and 15 percent increased risk of hospitalization due to related symptoms when exposed to antidepressants, according to a recent study published in the European Respiratory Journal. The new study led by researchers at St. Michael's Hospital.suggests that serotonergic antidepressants have higher rates of hospitalization, emergency room visits, and mortality related to respiratory conditions, as well as overall death versus non-users of the medications.

"We were not surprised by these findings, as there are biological reasons why antidepressants could lead to respiratory issues," said Dr. Nicholas Vozoris, a scientist in the Li Ka Shing Knowledge Institute of St. Michael's Hospital and the lead author. "These drugs can cause sleepiness, vomiting and can negatively impact immune system cells. This increases the likelihood of infections, breathing issues, and other respiratory adverse events, especially in patients with COPD."

Dr. Vozoris and his associates collected the data from health administrative databases from the Institute of Clinical Evaluative Sciences (ICES), and studied 28,360 new users of serotonergic antidepressants with COPD aged 66 and older and matched them to an equivalent amount of non-users.

The literature review showed that among older adults with COPD, new users of this class of medication have modest, but significant, increase in rates of breathing-related death and all causes of death. The research showed a strong association but could not provide a proper explanation for the cause and effect of such phenomenon.

Dr. Vozoris said that the study results should not cause alarm among those who use these medications, but rather increase caution among patients and physicians.

"I hope our study encourages increased awareness when prescribing these medications and monitoring for adverse side effects. Also, because there is this association, we as physicians should give thought to psychotherapy and pulmonary rehabilitation as non-drug related treatment", said Dr. Vozoris.

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs and affects more than 10 percent of those aged 40 and older worldwide.

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http://erj.ersjournals.com/content/early/2018/05/31/13993003.00475-2018