Clozapine and gastro‐oesophageal reflux disease (GORD) – an investigation of temporal association. (17th August 2012)

• Record Type: Journal Article
• Authors: van Veggel, M.; Olofinjana, O.; Davies, G.; Taylor, D.
• Is Part Of: Acta psychiatrica Scandinavica. Volume 127:Number 1(2013:Jan.)
• Page Start: 69
• Page End: 77
• Publication Date: 2012-08-17
• Subjects: Psychiatry -- Periodicals; 616.89
• DOI: 10.1111/j.1600-0447.2012.01920.x
• Languages: English
• ISSNs: 0001-690X

Abstract

<abstract abstract-type="main" xml:lang="en"> <title> <x xml:space="preserve">Abstract</x> </title> <p> <bold>Objective: </bold> To establish the temporal relationship between prescription of acid‐suppressant therapy, GORD and clozapine prescribing.</p> <p> <bold>Method: </bold> 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.</p> <p> <bold>Results: </bold> 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) <italic>P</italic> ≤ 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 (<italic>P</italic> = 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 (<italic>P</italic> = 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) <italic>P</italic> ≤ 0.0001].</p> <p> <bold>Conclusion: </bold> 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.</p> </abstract>