Imperial College London
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DrHannaCreese

Faculty of Medicine, School of Public Health

Research Associate
 
 
 
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h.creese

 
 
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Location

 

Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Blackwell:2021:10.1136/bmjgast-2020-000588,
author = {Blackwell, J and Alexakis, C and Saxena, S and Creese, H and Bottle, R and Petersen, I and Matthew, H and Pollok, R},
doi = {10.1136/bmjgast-2020-000588},
journal = {BMJ Open Gastroenterology},
title = {The association between antidepressant medication use and steroid dependency in patients with ulcerative colitis: a population-based study},
url = {http://dx.doi.org/10.1136/bmjgast-2020-000588},
volume = {8},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Animal studies indicate a potential protective role of antidepressant medication (ADM) in models of colitis but the effect of their use in humans with ulcerative colitis (UC) remains unclear. Objective: To study the relationship between ADM use and corticosteroid dependency in UC. Design: Using the Clinical Practice Research Datalink we identified patients diagnosed with UC between 2005-2016. We grouped patients according to serotonin selective reuptake inhibitor (SSRI) and tricyclic antidepressant (TCA) exposure in the 3 years following diagnosis: 'continuous users', 'intermittent users' and 'non users'. We used logistic regression to estimate the adjusted risk of corticosteroid dependency between ADM exposure groups. Results: We identified 6373 patients with UC. 5,230 (82%) use no ADMs, 627 (10%) were intermittent SSRI users and 282 (4%) were continuous SSRI users, 246 (4%) were intermittent TCA users and 63 (1%) were continuous TCA users. Corticosteroid dependency was more frequent in continuous SSRI and TCA users compared with non-users (19% vs. 24% vs. 14%, respectively, χ2 p=0.002). Intermittent SSRI and TCA users had similar risks of developing corticosteroid dependency to non-users (SSRI: OR 1.19, 95%CI 0.95-1.50, TCA: OR 1.14, CI 0.78-1.66). Continuous users of both SSRIs and TCAs had significantly higher risks of corticosteroid dependency compared to non-users (SSRI: OR 1.62, CI 1.15-2.27, TCA: OR 2.02, CI 1.07-3.81). Conclusions: Continuous ADM exposure has no protective effect in routine clinical practice in UC and identifies a population of patients requiring more intensive medical therapy. ADM use is a flag for potentially worse clinical outcomes in UC.
AU  - Blackwell,J
AU  - Alexakis,C
AU  - Saxena,S
AU  - Creese,H
AU  - Bottle,R
AU  - Petersen,I
AU  - Matthew,H
AU  - Pollok,R
DO  - 10.1136/bmjgast-2020-000588
PY  - 2021///
SN  - 2054-4774
TI  - The association between antidepressant medication use and steroid dependency in patients with ulcerative colitis: a population-based study
T2  - BMJ Open Gastroenterology
UR  - http://dx.doi.org/10.1136/bmjgast-2020-000588
UR  - http://hdl.handle.net/10044/1/88358
VL  - 8
ER  -
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