The patients with
Parkinson's disease (PD) are associated with a higher risk of
pneumonia.
Antidepressants exert an
anticholinergic effect in varying degrees and various classes of
antidepressants also can produce a different effect on immune function. The relationship between the risk of
pneumonia and the use of
antidepressants among elderly patients with PD is unknown. The study investigated the risk of
pneumonia associated with the use of
antidepressants in elderly patients with PD. This case-control study was based on data from the longitudinal health insurance database in Taiwan. We analyzed the data of 551,975 elderly patients with PD between 2002 and 2018. To reduce the potential confounding caused by unbalanced covariates in non-experimental settings, we used propensity score matching to include older patients without
pneumonia to serve as the comparison. The
antidepressants in the study included
tricyclic antidepressants (TCAs),
monoamine oxidase inhibitors (MAOIs),
selective serotonin reuptake inhibitors (
SSRIs),
serotonin, and norepinephrine reuptake inhibitors (
SNRIs). The conditional logistic regression was used to investigate the association between
antidepressants and
pneumonia. Control variables in the study included sex, age, income level, urbanization, Charlson comorbidity index score, and comorbidities related to
pneumonia. In terms of TCAs users, compared with patients not receiving TCAs, current users had a lower risk of incident
pneumonia (adjusted odds ratio [aOR] = 0.86, 95% CI = 0.82-0.90) and recent users (aOR = 0.83, 95% CI = 0.80-0.87). In terms of MAOIs users, current users had a lower risk of incident
pneumonia (aOR = 0.88, 95% CI = 0.83-0.93), recent users (aOR = 0.89, 95% CI = 0.85-0.93). In terms of
SSRIs users, current users had a higher risk of incident
pneumonia (a OR = 1.13, 95% CI = 1.01-1.17), recent users (aOR = 1.01, 95% CI = 1.06-1.13), and past users (aOR = 1.19, 95% CI = 1.17-1.21). In terms of
SNRIs users, past users had a higher risk of incident
pneumonia (aOR = 1.07, 95% CI = 1.03-1.10). The incident
pneumonia is associated with the use of individuals of different classes of
antidepressants. The use of TCAs (such as,
amitriptyline and
imipramine) had a lower odds of incident
pneumonia. The use of MAOIs (such as,
selegiline and
rasagiline) had a lower odds of
pneumonia during recent use. The use of
SSRIs (such as,
fluoxetine,
sertraline,
escitalopram,
paroxetine, and
citalopram) and
SNRIs (such as,
milnacipran, and
venlafaxine) had a higher odds of incident
pneumonia.