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Medientyp:
E-Artikel
Titel:
PSYCHIATRIC SEQUELAE OF CALCIUM CHANNEL BLOCKERS – PRELIMINARY RESULTS FROM A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Beteiligte:
Fürtig, Marc-Alexander;
Kovalenko, Yana;
Kreutz, Reinhold;
Riemer, Thomas Günther
Beschreibung:
<jats:sec>
<jats:title>Objective:</jats:title>
<jats:p>L-type Calcium Channel Blockers (CCB) are widely used in the treatment of hypertension and other cardiovascular diseases. The risk of adverse events such as hypotension and edema for dihydropyridine-CCB (DHP), and bradycardia, atrioventricular block, and constipation for non-dihydropyridine-CCB (non-DHP) is well known. In addition, CCB have also been suspected of causing psychiatric adverse events (PAE). In our study, we evaluate the risk of PAE during CCB therapy.</jats:p>
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<jats:sec>
<jats:title>Design and method:</jats:title>
<jats:p>We conducted a systematic search in literature databases and clinical trial registries to identify placebo-controlled randomized controlled trials (RCT) that reported frequencies of PAE during CCB therapy. We extracted data on frequencies of PAE and reviewed them, taking into account the total number of exposed patients. We separately calculated odds ratios (OR) with a 95% confidence interval (CI) for PAE in users of DHP or non-DHP CCB.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results:</jats:title>
<jats:p>We retrieved 86 eligible placebo-controlled studies, encompassing 14,585 patients exposed to CCB. Main indications for CCB use were hypertension (64 studies) and angina pectoris (11 studies). PAE were reported in 1,425 patients, with fatigue, depression, agitation, and insomnia accounting for most of cases (299, 272, 113, and 105 respectively). Meta-analyses were possible for eight symptoms in DHP studies and for two symptoms in non-DHP studies, with a total of 73 RCT contributing data. We found no significant differences between the risk of PAE during DHP (anxiety (OR = 0.85; CI = 0.47–1.54; p = 0.58), depression (OR = 0.87; CI = 0.73–1.03; p = 0.11), unusual dreams (OR = 0.92; CI = 0.47–1.80; p = 0.80), fatigue (OR = 1.15; CI = 0.91–1.46; p = 0.24), insomnia (OR = 0.90; CI = 0.62–1.29; p = 0.55), nervousness (OR = 1.18; CI = 0.87–1.59; p = 0.29), sleep disorders (OR = 1.26; CI = 0.68–2.33; p = 0.47), and somnolence (OR = 1.15; CI = 0.77–1.71; p = 0.49) or non-DHP (fatigue (OR = 1.32; CI = 0.76–2.27; p = 0.32) and insomnia (OR = 0.94; CI = 0.31–2.86; p = 0.92)) compared to placebo.</jats:p>
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<jats:sec>
<jats:title>Conclusions:</jats:title>
<jats:p>PAE are occasionally reported during CCB therapy but not more frequently than during placebo. Therefore, CCB do not impose a risk of psychiatric sequelae and can be considered safe regarding mental health.</jats:p>
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