在老年养老院居民中,与特拉马多尔和抗抑郁药物的同时使用相关的发作风险
Yu-Jung Jenny Wei1, Almut G Winterstein2,3,4, Siegfried Schmidt5
1Division of Pharmaceutics and Pharmacology, College of Pharmacy, The Ohio State University, Columbus.
Neurology
|October 8, 2025
概括
将特拉马多尔与抑制细胞染色体P450 2D6 (CYP2D6) 的抗抑郁药物结合使用,会增加老年人发作的风险. 与使用特拉马多尔与CYP2D6中性抗抑郁药相比,这种风险更高,特别是在养老院居民中.
科学领域:
- 老年人药理学 老年人药理学
- 临床药房 临床药房
- 药学流行病学 药学流行病学
背景情况:
- 怀疑特拉马多尔和某些抗抑郁药的同时使用会增加老年人发作风险.
- 抗抑郁药对细胞染色体P450 2D6 (CYP2D6) 酶的强烈抑制是主要引起关注的机制.
- 在现实世界的人口中,特别是在养老院环境中,关于这种关联的经验数据有限.
研究的目的:
- 为了研究同步使用特拉马多尔和抑制CYP2D6的抗抑郁药与CYP2D6中性抗抑郁药之间的关联.
- 评估在养老院 (NHs) 的老年居民中发作风险.
主要方法:
- 一项基于人口的队列研究利用了2010年至2021年100%的医疗保险NH样本.
- 包括65岁以上的长期居民,他们开始服用特拉马多尔或抗抑郁药.
- 使用回归模型分析了发作风险,对基线共变量进行加权,比较CYP2D6抑制剂与CYP2D6中性抗抑郁药.
主要成果:
- 这项研究包括11,162名特拉马多尔抗抑郁药使用者和58,994名抗抑郁药使用者,平均年龄为85岁以上.
- 发作发生率分别为每100个患者年分别为16.10和20.17.
- 与CYP2D6抑制抗抑郁药同时使用的特拉马多尔显示出更高的发作调整发病率比率 (1.09和1.06).
结论:
- 与抑制CYP2D6的抗抑郁药同时使用特拉马多尔与老年NH居民的发作风险增加有关.
- 临床医生应谨慎对待使用特拉马多尔与抑制CYP2D6的抗抑郁药的老年患者的发作风险.
- 研究结果可将其推广到长期NH种群中,并提供II类证据.
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