Association between antidepressant medication use and steroid dependency in patients with ulcerative colitis: a population-based study

Background Animal studies indicate a potential protective role of antidepressant medication (ADM) in models colitis but the effect their use humans with ulcerative (UC) remains unclear. Objective To study relationship between ADM and corticosteroid dependency UC. Design Using Clinical Practice Research Datalink we identified patients diagnosed UC 2005 2016. We grouped according to serotonin selective reuptake inhibitor (SSRI) tricyclic (TCA) exposure 3 years following diagnosis: ‘continuous users’, ‘intermittent users’ ‘non-users’. used logistic regression estimate adjusted risk groups. Results 6373 Five thousand two hundred thirty (82%) no ADMs, 627 (10%) were intermittent SSRI users 282 (4%) continuous users, 246 TCA 63 (1%) users. Corticosteroid was more frequent compared non-users (19% vs 24% 14%, respectively, χ 2 p=0.002). Intermittent had similar risks developing (SSRI: OR 1.19, 95% CI 0.95 1.50, TCA: 1.14, 0.78 1.66). Continuous both SSRIs TCAs significantly higher 1.62, 1.15 2.27, 2.02, 1.07 3.81). Conclusions has routine clinical practice identifies population requiring intensive medical therapy. is flag for potentially worse outcomes