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Association of use of selective serotonin reuptake inhibitors with risk of acute pancreatitis: a case-control study in Taiwan

European Journal of Clinical Pharmacology volume 73, pages 1615–1621 (2017)Cite this article

Abstract

Background and objectives

Few studies have reported the association of the use of selective serotonin reuptake inhibitors (SSRIs) with acute pancreatitis. We conducted a population-based case-control study to explore this relationship.

Methods

In this study, 4631 cases with first attack of acute pancreatitis and 4631 controls without acute pancreatitis were selected using a randomly sampled cohort of one million health insurance enrollees from 2000 to 2013. Both cases and controls were aged 20–84 years and were matched with sex, age, comorbidities, and index year of diagnosis of acute pancreatitis. Patients with current use of SSRIs were defined as those whose last tablet of SSRIs was noted ≤ 7 days before the date of diagnosis of acute pancreatitis; patients with late use of SSRIs were defined as those whose last tablet of SSRIs was noted ≥ 8 days before the date of diagnosis; and patients with no use of SSRIs were defined as those who were never prescribed SSRIs. The odds ratio (OR) and 95% confidence interval (CI) for acute pancreatitis associated with the use of SSRIs were assessed using multivariate unconditional logistic regression analysis.

Results

After adjusting for covariables, multivariate logistic regression analysis revealed that compared with patients with no use of SSRIs, the adjusted OR of acute pancreatitis for those with current use of SSRIs was 1.7 (95% CI, 1.1–2.5), whereas that for patients with late use of SSRIs was 1.0 (95% CI, 0.9–1.2) without statistical significance.

Conclusions

Current use of SSRIs is associated with the diagnosis of acute pancreatitis. Therefore, clinicians should consider the possibility of SSRI-associated acute pancreatitis among patients currently taking SSRIs and those presenting with the diagnosis of acute pancreatitis without a definite cause.

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Fig. 1

Abbreviations

ICD-9 code:

International Classification of Diseases 9th Revision Clinical Modification

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Funding information

This study was supported in part by Taiwan Ministry of Health and Welfare Clinical Trial Center (MOHW106-TDU-B-212-113004), China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10601010036), Taiwan Clinical Trial Consortium for Stroke (MOST 106-2321-B-039-005), Tseng-Lien Lin Foundation in Taichung in Taiwan, Taiwan Brain Disease Foundation in Taipei in Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds in Japan. These funding agencies did not influence the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Author notes

  1. Hsien-Feng Lin, Kuan-Fu Liao and Ching-Mei Chang contributed equally to this work.

Affiliations

  1. School of Chinese Medicine, China Medical University, Taichung, Taiwan

    Hsien-Feng Lin

  2. Department of Family Medicine, China Medical University Hospital, No 2, Yuh-Der Road, Taichung City, 404, Taiwan

    Hsien-Feng Lin & Shih-Wei Lai

  3. Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan

    Kuan-Fu Liao

  4. College of Medicine, Tzu Chi University, Hualien, Taiwan

    Kuan-Fu Liao

  5. Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan

    Kuan-Fu Liao

  6. Department of Nursing, Tungs’ Taichung Metro Habor Hospital, Taichung, 435, Taiwan

    Ching-Mei Chang

  7. College of Medicine, China Medical University, Taichung, Taiwan

    Cheng-Li Lin & Shih-Wei Lai

  8. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    Cheng-Li Lin

Authors
  1. Hsien-Feng Lin
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  2. Kuan-Fu Liao
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  3. Ching-Mei Chang
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  4. Cheng-Li Lin
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  5. Shih-Wei Lai
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Contributions

Hsien-Feng Lin and Kuan-Fu Liao substantially planned and conducted this study, participated in the data interpretation, and also critically revised the article.

Ching-Mei Chang and Cheng-Li Lin conducted the data analysis and critically revised the article.

Shih-Wei Lai substantially planned and conducted this study, contributed to the conception of the article, initiated the draft of the article, and critically revised the article.

Corresponding author

Correspondence to Shih-Wei Lai.

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Lin, HF., Liao, KF., Chang, CM. et al. Association of use of selective serotonin reuptake inhibitors with risk of acute pancreatitis: a case-control study in Taiwan. Eur J Clin Pharmacol 73, 1615–1621 (2017). https://doi.org/10.1007/s00228-017-2328-x

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  • DOI: https://doi.org/10.1007/s00228-017-2328-x

Keywords

  • Acute pancreatitis
  • Selective serotonin reuptake inhibitors