Comment
Author: Admin | 2025-04-28
Drugs (ROR: 14.26, 95% CI 14.08–14.45; IC: 3.34, 95% CI 3.32–3.35). When comparing single antidepressant classes to all other drugs, other antidepressants had the highest ROR (17.01, 95% CI 16.73–17.29; IC: 3.75, 95% CI 3.73–3.77), followed by SSRIs (ROR: 13.65, 95% CI 13.41–13.90; IC: 3.50, 95% CI 3.47–3.52) and TCAs (ROR: 2.80, 95% CI 2.59–3.02; IC: 1.46, 95% CI 1.46–1.55). We also found a statistically significant disproportionality for most individual antidepressants, when analysed separately (Table 2). The strongest disproportionality signals were found for paroxetine, duloxetine, venlafaxine and desvenlafaxine (Fig. 1). The ROR and IC values with 95% CI for all antidepressants are reported in Table 2.Fig. 1Reporting odds ratios (RORs) and 95% confidence intervals (CI) for each antidepressant (ROR > 1 indicates an increased withdrawal risk associated with antidepressants) – all other drugs were considered as comparatorsFull size image3.3 Antidepressants Versus BuprenorphineWhen comparing to buprenorphine, the signal of disproportionate reporting for antidepressants as a group remained, although the ROR (1.45; 95% CI 1.40–1.51) was much lower than in the main analysis. The analyses by class showed a statistically significant disproportionate reporting versus buprenorphine only for other antidepressants (ROR = 1.73, 95% CI 1.67–1.81) and SSRIs (ROR = 1.39, 95% CI 1.34–1.45), but not for TCAs (ROR = 0.29, 95% CI 0.26–0.31). Analysis of individual antidepressants versus buprenorphine documented signals of disproportionate reporting (ranked by ROR) only for paroxetine, duloxetine, venlafaxine and desvenlafaxine (ESM Table 3).Table 3 Comparison between serious and non-serious reactionsFull size table3.4 Antidepressant Intraclass ComparisonThe intraclass disproportionality analysis of withdrawal syndrome showed that some antidepressants had higher disproportionate reporting of withdrawal syndrome than others belonging to the same class. Withdrawal syndrome was disproportionately reported only for clomipramine and imipramine among TCAs (ESM Table 4), only paroxetine among SSRIs (ESM Table 5), and among other antidepressants, duloxetine, venlafaxine and desvenlafaxine (ESM Table 6).3.5 Comparison of Serious Versus Non-serious ReportsPatients with serious withdrawal syndrome were slightly younger than patients with non-serious withdrawal syndrome (43.51 ± 14.68 vs 45.87 ± 14.57 years, Table 3), with adolescents showing a significantly higher number of serious reactions compared to adults (OR: 2.14, 95% CI 1.55–3.01). Males had higher probability of having serious withdrawal reactions than females (OR: 1.21, 95% CI 1.14–1.29). Additionally, cases with serious reactions had, on average, longer treatment duration, with a mean duration of treatment of 25.55 ± 36.88 months versus 17.91 ± 32.96 months for cases with non-serious reactions (p
Add Comment