Browsing by Author "Chu, Che-Sheng"

Now showing 1 - 4 of 4

Antidepressants and risk of cataract development: A population-based, nested case-control study
(2017-06-01)
Chou, Po-Han
;
Chu, Che-Sheng
;
Chen, Yi-Huei
;
Hsu, Min-Yen
;
Huang, Min-Wei
Background: Previous studies demonstrated increased risk of cataract development among users of selective serotonin reuptake inhibitors (SSRIs). However, it remains unknown whether this risk also prevails with the use of other types of antidepressants. The aim of this study was to investigate whether use of antidepressants is associated with an increased risk of cataract development. Moreover, the relationship between binding affinities of serotonin transporter (SERT) of antidepressant and the risk of cataracts is examined. Methods: We conducted a nested case-control study using National Health Insurance Research Database in Taiwan. A total of 14,288 patients were included; 7651 in the cataract group and 6637 in the control group. Antidepressant exposure was categorized by type, duration of use, and binding affinities of SERT. The association between antidepressant exposure and cataract development was assessed using conditional logistic regression analysis. Results: The adjusted odds ratios (AORs) for developing cataracts among continuous users of SSRIs, serotonin norepinephrine reuptake inhibitors (SNRIs), and other antidepressants were 1.26 (95% confidence interval (CI): 1.12-1.41, p < 0.001), 1.21 (95% CI: 1.02-1.43, p=0.027), and 1.18 (95% CI: 1.04-1.34, p=0.009) respectively. Specifically, continuous uses of fluoxetine (AOR: 1.21; 95% CI: 1.01-1.46, p=0.042), fluvoxamine (AOR: 1.47; 95% CI: 1.01-2.12, p=0.043), venlafaxine (AOR: 1.44; 95% CI: 1.19-1.74, p < 0.001) significantly increased the risk of cataract development. Moreover, continuous users of antidepressants with intermediate SERT binding affinities (AOR: 1.68; 95% CI: 1.10-2.56, p=0.017) were significantly associated with increased risks of cataract development. Limitations: Several confounding factors such as obesity, multiple drug users, family history of cataracts, substance use, and environmental factors (such as sunlight or radiation exposure) were acquired. Conclusions: We found increased risk of cataract development in patients continuously using antidepressants. Regular ocular evaluations in these patients are warranted.
Association between antipsychotic drug use and cataracts in patients with bipolar disorder: A population-based, nested case-control study
(2017-02)
Chu, Che-Sheng
;
Chou, Po-Han
;
Chen, Yi-Huei
;
Huang, Min-Wei
;
Hsu, Min-Yen
Background: No previous study has focused on the association between use of antipsychotic drugs and the development of cataracts in patients with bipolar disorder (BD); hence, we aimed to examine this association in the present study. Methods: We conducted a retrospective nested case-control study using data from the National Health Insurance Database of Taiwan between 2000 and 2011. A. total of 3292 BD patients, 1684 with cataracts and 1608 controls matched for age, sex, and index date, were included. Antipsychotic drug exposure was categorized by type of drug and duration of use. A conditional logistic regression analysis was used to analyze the association. Results: Among BD patients, we found significantly reduced odds ratio (OR) of cataract development among past (adjusted OR (AOR), 0.74; 95% confidence interval (CI), 0.62-0.89; p=0.001) and continuous users (AOR, 0.71; 95% CI, 0.59-0.85; p < 0.001) of atypical antipsychotics. No association was found between the odds of cataract development and typical antipsychotics. Besides, concomitant use of antidepressants (AOR, 1.23; 95% CI, 1.06-1.43; p=0.007) and mood stabilizers (AOR, 1.23; 95% CI, 1.06-1.42; p=0.007) were associated with increased odds of cataract development. Limitations: Some important contributors to cataract development such as family history of cataract, smoking and alcohol exposure could not be measured from the claims data and this may confound the results. Conclusions: Reduced odds of cataract were found in patients with BD taking atypical antipsychotics. However, given that BD patients often have risk factors for developing cataract, regular ocular evaluations are recommended for those treated with antipsychotics drugs.
Associations between use of mood stabilizers and risk of cataract: A population-based nested case-control study
(2018-02-01)
Chu, Che-Sheng
;
Lin, Ching-Heng
;
Lan, Tsuo-Hung
;
Chou, Po-Han
;
光電工程學系
Background: The aim of this study was to investigate whether use of mood stabilizers (MS) is associated with an increased risk of cataract development. Methods: We conducted a nested case-control study using National Health Insurance Research Database in Taiwan. A total of 14,288 patients with bipolar disorder (BD) and schizophrenia were included; 7651 in the cataract group and 6637 in the control group. Based on overall cumulative period of MS (lithium, carbamazepine, valproate, and lamotrigine) treatment, we categorized into following groups: no use, and duration < 1 year, 1 to 2 years, and > 2 years. Conditional logistic regression analysis was used to explore the association between use of MS and risk of cataract development. Results: The risks for cataract development were significantly higher in patients using lithium alone and lithium combined with other MS for more than 2 years (adjusted odd ratio [AOR] = 1.39; 95% CI= 1.01-1.92, p = 0.043 and AOR = 1.44; 95% CI = 1.13-1.85, p = 0.003, respectively) than in non-users. Furthermore, the risks of cataract development increased in those treated with valproic acid combined with other MS (AOR = 1.26; 95% CI= 1.02-1.57, p = 0.035). Finally, no increased risks of cataract development were found in carbamazepine and lamotrigine users. Conclusions: We found increased risks of cataract development in long-term users of lithium, lithium combined with other MS and valproic acid combined with other MS for more than two years among patients with BD and schizophrenia.
Use of Selective Serotonin Reuptake Inhibitors and Risks of Stroke in Patients with Obsessive Compulsive Disorder: A Population-Based Study
(2016-09-09)
Chu, Che-Sheng
;
Chou, Po-Han
;
Lin, Ching-Heng
;
Cheng, Chin
;
Tsai, Chia-Jui
Background Previous research has suggested a link between antidepressants use and the development of cerebrovascular events, but there has never been any study investigating the risk of stroke in obsessive-compulsive disorder (OCD) patients treated with a selective serotonin reuptake inhibitor (SSRI). Methods A retrospective observational cohort study was conducted using data from the National Health Insurance Database of Taiwan between the year of 2001 and 2009. A total of 527 OCD patients with 412 subjects in the SSRI use group and 115 in the non SSRI use group were included. Multivariable Cox proportional-hazards models were used to explore the associations between SSRI use and the occurrence of stroke, controlling for age, gender, concomitant medications, and comorbid medical illnesses. Results A total of nineteen OCD patients were diagnosed with new onset of stroke during the follow-up period including six cases in the SSRI group and thirteen in the non SSRI use group. SSRI use was demonstrated to be associated with a decreased risk of stroke (hazard ratio [HR] = 0.30; 95% confidence interval [CI] = 0.10-0.86, P = 0.02). The increase in age-related risk of strokes was 2.55 per decade (HR = 2.55; 95% CI = 1.74-3.75, P<0.001). Alternatively, sex, concomitant use of aspirin and non-steroidal anti-inflammatorydrugs, and comorbidities with angina pectoris, diabetes mellitus, hypertension, and hyperlipidemia were not found to be associated with an increased risk for stroke in OCD patients. Conclusions Our study showed that SSRI use was associated with decreased risk of stroke in OCD patients. Further investigation into the possible biological mechanisms underlying the relationship between stroke and SSRI use in OCD patients is warranted.