Document Detail


Clozapine and gastro-oesophageal reflux disease (GORD) - an investigation of temporal association.
MedLine Citation:
PMID:  22901096     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
van Veggel M, Olofinjana O, Davies G, Taylor D. Clozapine and gastro-oesophageal reflux disease (GORD) - an investigation of temporal association. Objective:  To establish the temporal relationship between prescription of acid-suppressant therapy, GORD and clozapine prescribing. Method:  In this retrospective cohort study, we identified out-patients prescribed clozapine and other atypical antipsychotics (AAP) and compared times and rates of prescribing of acid-suppressant therapy. Odds ratios were calculated. Results:  Of 352 patients on clozapine and 358 patients on other AAP, there were 74 (21.0%) and 23 (6.7%) patients prescribed acid-suppressant therapy respectively [OR = 3.9 (95% CI: 2.4-6.4) P ≤ 0.0001]. In 67 of 74 cases (90.5%) vs. 18 of 23 cases (81.8%), acid-suppressant therapy began after the start of the antipsychotic. Clozapine patients were more likely to be prescribed acid-suppressant therapy within the first 5 years of initiation than those on other AAP (P = 0.039). Where indication for acid-suppressant therapy was known, it was prescribed for GORD in 44 of 62 (71.0%) of the clozapine patients and 6 of 13 (46.2%) of those on other AAP (P = 0.109). Rate of known GORD was 44 of 352 (12.5%) for clozapine and 6 of 358 (1.7%) for other atypicals [OR = 8.4 (95% CI: 3.5-19.9) P ≤ 0.0001]. Conclusion:  Clozapine was associated with higher rates of GORD and acid-suppressant therapy prescribing than other AAP. There was a clear temporal relationship between the prescribing of clozapine and the later use of acid-suppressant therapy. These observations strongly suggest that prescription of clozapine was associated with the onset of GORD.
Authors:
M van Veggel; O Olofinjana; G Davies; D Taylor
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-17
Journal Detail:
Title:  Acta psychiatrica Scandinavica     Volume:  -     ISSN:  1600-0447     ISO Abbreviation:  Acta Psychiatr Scand     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370364     Medline TA:  Acta Psychiatr Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 John Wiley & Sons A/S.
Affiliation:
Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Utrecht University, Utrecht, the Netherlands Institute of Pharmaceutical Science, King's College, London Department of Pharmacy, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK.
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