METHODS: We searched the Medline, Web of Science and Embase databases to identify reported cases of peripheral oedema associated with antidepressant use. We included studies published in English and those with full-text availability. A systematic review of the reports was done to identify the antidepressants associated with oedema, explore possible risk factors, investigate potential mechanisms, and assess the outcome.
RESULTS: We identified a total of 45 cases (27 case reports and five case series) that reported oedema associated with antidepressant use. Almost all major classes of antidepressants were found to be associated with oedema. Among these drugs, trazodone, mirtazapine, and escitalopram were the most implicated. Older age and female gender were more commonly associated with oedema. Etiologically, antagonism of α1 adrenergic receptors and 5HT2A receptors, leading to vasodilation and oedema, emerged as the most prevalent mechanisms. In most cases, the oedema subsided following the discontinuation of the antidepressants.
CONCLUSIONS: Peripheral oedema associated with antidepressant use can represent a significant adverse drug reaction involving various classes of antidepressants. To ensure timely identification and proper management of oedema, regular monitoring is crucial.
方法:我们搜索了Medline,WebofScience和Embase数据库,以确定报告的与抗抑郁药使用相关的外周水肿病例。我们包括以英语发表的研究和具有全文可用性的研究。对这些报告进行了系统评价,以确定与水肿相关的抗抑郁药,探索可能的危险因素,调查潜在的机制,并评估结果。
结果:我们确定了总共45例(27例病例报告和5例系列)报告与抗抑郁药使用相关的水肿。发现几乎所有主要类型的抗抑郁药都与水肿有关。在这些药物中,曲唑酮,米氮平,艾司西酞普兰的牵连最严重.年龄较大和女性更常见于水肿。病因学上,α1肾上腺素能受体和5HT2A受体的拮抗作用,导致血管舒张和水肿,成为最普遍的机制。在大多数情况下,停用抗抑郁药后水肿消退。
结论:与抗抑郁药使用相关的外周性水肿可代表涉及各类抗抑郁药的显著药物不良反应。为了确保及时识别和正确管理水肿,定期监测至关重要。