抗抑郁药加抗血栓药与出血风险的关联:一项药监测研究
Jean-Louis Montastruc1, Alessandra Bura-Rivière2,3
1Clinical Pharmacologist, Toulouse, France. jean-louis.montastruc@univ-tlse3.fr.
European journal of clinical pharmacology
|December 19, 2023
概括
将选择性色素再吸收抑制剂 (SRIs) 添加到抗血栓剂中,会增加严重出血事件的风险. 非选择性单胺重吸收抑制剂 (NSMRIs) 在与抗血栓剂结合时没有显示出这种增加的出血风险.
科学领域:
- 药物监督 药物监督 药物监督
- 临床药理学 临床药理学
- 药品安全 药品安全
背景情况:
- 抗抑郁药和抗血栓剂是经常被处方的药物.
- 同时使用这些药物类别可能会造成出血风险.
- 了解药物相互作用对于患者的安全至关重要.
研究的目的:
- 为了调查抗抑郁药与抗血栓剂同时使用时可能增加严重出血的风险.
- 为了比较特定类型的抗抑郁药和抗血栓剂之间的出血风险.
主要方法:
- 使用VigiBase®,世卫组织药监数据库,用于2000-2022年的数据.
- 员工报告几率比 (ROR) 评估药物组合与严重出血之间的关联.
- 抗抑郁药 + 抗血栓使用与抗血栓单一治疗的比较.
主要成果:
- 选择性色素再吸收抑制剂 (SRIs) 与直接口服抗凝剂 (DOACs) 结合,显示出出血风险增加 (ROR=1.49).
- 这种高风险在各种抗血栓剂中观察到,包括维生素K对抗剂,血小板聚合抑制剂和肝素.
- 非选择性单胺再吸收抑制剂 (NSMRIs) 在与抗血栓剂一起使用时没有显示出与增加出血的显著关联.
结论:
- 同时使用SRIs和抗血栓剂与更高的严重出血风险有关.
- 观察到的出血风险扩展到所有类型的抗血栓剂,而不仅仅是DOACs.
- 在与抗血栓剂相结合时,NSMRIs似乎是一个更安全的替代方案,可以避免出血风险.
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