启动不同抗抑郁药子类对老年患有抑郁症的老年人中机动车祸风险的影响
Marzan A Khan1,2, Nina R Joyce1,2, Melissa R Pfeiffer3
1Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.
Journal of the American Geriatrics Society
|May 20, 2025
概括
抗抑郁药物子类,包括非典型 (AA),三环 (TCA) 和选择性血清素再吸收抑制剂 (SSRI) 类型,在老年人机动车辆事故 (MVC) 风险上没有显著差异. 对于抑郁症管理的处方决定,应该优先考虑其他因素而不是MVC风险.
科学领域:
- 老年人药理学老年人药理学
- 公共卫生和公共安全.
- 药物不良事件的流行病学
背景情况:
- 抗抑郁药通常用于老年人的抑郁症.
- 抗抑郁药的副作用,如镇静和头,可能会增加机动车辆事故 (MVC) 的风险.
- 不同的抗抑郁药子类可能会对MVC带来不同的风险,原因是不同的不良影响概况.
研究的目的:
- 为了比较与启动非典型抗抑郁药 (AAs) 或三环抗抑郁药 (TCAs) 与选择性血清素再吸收抑制剂 (SSRI) 相关的机动车辆事故 (MVCs) 的一年风险,在老年人中.
- 通过评估MVC比较风险,为有关老年人群抗抑郁药物选择的临床决策提供信息.
主要方法:
- 从2008-2017年每周模拟470个连续的目标试验,使用与MVC和驾驶执照记录相关的医疗保险索赔数据.
- 包括最近被诊断患有抑郁症的老年人 (≥66岁) 开始AA,SSRI或TCA.
- 应用治疗和审查的逆概率加权卡普兰-梅尔估计器来确定MVC的一年累积发病率和风险比率 (RRs).
主要成果:
- 这项研究分析了来自11,604个人的13,034个人体试验 (平均年龄76岁,女性69.8%).
- 每1000人试验的MVC率为TCA的37.6,AA的37.6和SSRI的38.0.
- 调整后的风险比率没有显著差异:0.99 (95%CLs0.72,1.56) 对于AAs与SSRIs,0.99 (95%CLs0.56,1.86) 对于TCAs与SSRIs.
结论:
- 在非典型抗抑郁药,三环抗抑郁药和选择性血清素再吸收抑制剂之间,在一年的机动车祸风险上没有显著差异.
- 在选择抗抑郁药子类来治疗老年人抑郁症时,机动车祸风险不应该是主要因素.
- 在这种人群中,其他临床考虑因素应指导抗抑郁药物处方决策.
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