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Serotonergic antidepressant use and morbidity and mortality among older adults with COPD



Nicholas Vozoris, Xuesong Wang, Peter Austin, et al.
Eur Respir J 2018;52:1800475
doi:10.1183/13993003.00475-2018

Psychiatric disorders are common in patients affected by chronic obstructive pulmonary disease (COPD), with depression and anxiety being documented in 70–80% of COPD patients. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) are recommended as first-line pharmacotherapy for these psychiatric disorders, with some theorising that these therapies may indirectly improve respiratory health outcomes in COPD.

In this population-based, retrospective cohort study, researchers investigated the relationship between SSRI/SNRI use and respiratory morbidity and mortality in COPD patients aged ≥66 years.

Compared with non-users, new users of SSRIs and SNRIs demonstrated modest but significantly higher rates of respiratory-related morbidity and mortality, with results demonstrating higher rates of hospitalisation, emergency department visits and mortality related to COPD and pneumonia.

Conclusions suggested that SSRIs and SNRIs may have deleterious effects on the respiratory system, which would explain the higher rates of morbidity and mortality recorded in those using SSRIs and SNRIs. Although compelling, it is important to remember that these data only represent a relationship between these factors, not cause and effect. Therefore, more research is required to understand the full relationship between psychiatric therapy use and respiratory-related morbidity and mortality in older COPD patients.




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