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首页> 外文期刊>Pharmacoepidemiology and drug safety >Drug or symptom-induced depression in men treated with alpha 1-blockers for benign prostatic hyperplasia? A nested case-control study.
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Drug or symptom-induced depression in men treated with alpha 1-blockers for benign prostatic hyperplasia? A nested case-control study.

机译：用α1受体阻滞剂治疗男性良性前列腺增生的药物或症状引起的抑郁症？嵌套的病例对照研究。

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PURPOSE: Regulatory authorities have raised concern that alpha 1-blockers, prescribed predominantly for benign prostatic hyperplasia (BPH), may be associated with an increased risk of depression. The aim was to assess the risk of depression with alpha 1-blockers independently of that associated with symptoms being treated and concurrent illness. METHODS: Using a study population registered on the UK General Practice Research Database, and taking a prescription for an antidepressant as a proxy for clinical depression, we performed: (a) cohort analyses comparing the incidence of depression in current users of alpha 1-blockers versus non-users, and in men with BPH versus those without. (b) A nested case-control analysis looking at the association between depression and alpha 1-blocker exposure, accounting for the presence of BPH and other illness. RESULTS: In the cohort analyses, risk of depression was significantly higher in men with BPH compared to those without (IRR 2.17, 2.12-2.22), but was not significantly different for men exposed to alpha 1-blockers versus those unexposed when adjusted for the presence of BPH. Cases of depression were more likely to have pre-existing BPH (crude OR 2.09, 2.02-2.15) than controls. After adjusting for concurrent illness (using number of GP visits as a proxy) and the presence of BPH (adjusted OR 1.38, 1.33-1.43), there was no association with depression for exposure to any alpha 1-blocker (adjusted OR 1.03, 0.90-1.18). CONCLUSIONS: This study did not suggest that the prescribing of alpha 1-blockers increases the risk of being depressed. The association highlighted by spontaneous reporting systems appears to be explained by confounding by concurrent disease.
机译：目的：监管部门已经引起关注，主要针对良性前列腺增生（BPH）而开具的α1受体阻滞剂可能会增加患抑郁症的风险。目的是评估与α1-受体阻滞剂相关的抑郁症风险，与与正在治疗的症状和并发疾病无关。方法：我们使用在UK General Practice Research Database上注册的研究人群，并以抗抑郁药的处方作为临床抑郁症的替代药物，我们进行了以下研究：（a）队列分析，比较了当前使用α1受体阻滞剂的抑郁症的发生率与非使用者相比，有BPH的男性与没有BPH的男性。 （b）嵌套的病例对照分析，研究了抑郁症与α1-受体阻滞剂暴露之间的关系，并解释了BPH和其他疾病的存在。结果：在队列分析中，患有BPH的男性抑郁症的患病风险显着高于未患有BPH的男性（IRR 2.17，2.12-2.22），但接受α1-受体阻滞剂治疗的男性与未接受暴露水平调整的男性相比，抑郁风险无显着差异。 BPH的存在。抑郁症患者比对照组更可能患有预先存在的BPH（粗略的OR 2.09，2.02-2.15）。在调整并发疾病（使用全科医生就诊次数作为代理人）和BPH的存在（调整后的OR 1.38，1.33-1.43）之后，暴露于任何α1受体阻滞剂与抑郁症没有关联（调整后的OR 1.03，0.90） -1.18）。结论：这项研究并未提示开α1受体阻滞剂会增加患抑郁症的风险。自发报告系统突出显示的关联似乎是由并发疾病引起的。

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