Table 3.

Summary of studies of exposure to antidepressants and risk of pneumonia included in review

Study, year, country and data source	Study type	Participants (sample size)	Age (years)	Accommodation	Confounders adjusted for	Population	Drugs investigated	Exposure definition	Comparison group	Outcome or case definition	Risk of pneumonia
Cohort studies
Vozoris et al. [131], 2018, Canada, linked health care databases	Cohort	New users (n = 28,360), non-users (n = 28,360)	> 65	Community-dwelling	Propensity-score matching	COPD	SSRIs, SNRIs	SSRI or SNRI initiation	Non-users	Hospitalization for COPD exacerbation or pneumonia	HR 1.15, 95% CI 1.03–1.25
Huybrechts et al. [130], 2011, Canada, linked health care databases	Cohort	New antidepressant users (n = 4887), new SGA users (n = 1942)	≥ 65	Nursing homes	Propensity score	N/A	Antidepressants	Antidepressant or SGA initiation after admission to nursing home	SGA users	Hospitalization for pneumonia within 180 days of drug initiation	RR 1.09, 95% CI 0.73–1.65
Case–control studies
Hennessy et al. [125], 2007, UK, General Practice Research Database	Case–control	Cases (n = 12,044) pneumonia dg, controls (n = 48,176) no hospitalization for pneumonia	≥ 65	Not reported	Matched 1:4 for General Practitioner practice, adjusted covariates	N/A	Antidepressants	Antidepressant initiation	Non-users	Hospitalization for pneumonia	aOR 0.89, 95% CI 0.79–1.00

aOR adjusted odds ratio, CI confidence interval, COPD chronic obstructive pulmonary disorder, dg diagnosis, HR hazard ratio, N/A not available, RR risk ratio, SGA second-generation antipsychotic, SNRI serotonin-norepinephrine reuptake inhibitor, SSRI selective serotonin reuptake inhibitor