Association of serotonin reuptake inhibitors with asthma control

Allergy Asthma Proc. 2023 Sep 1;44(5):354-360. doi: 10.2500/aap.2023.44.230043.

Abstract

Background: Clinical trials demonstrated that selective serotonin reuptake inhibitors (SSRI) can improve asthma control in patients with comorbid major depressive disorder (MDD) and that this effect may be greater than the effect of SSRIs on depression. These findings suggest that SSRIs may improve asthma control in patients without MDD. Objective: The current retrospective study examined the effect of SSRIs and serotonin and norepinephrine reuptake inhibitors (SNRI) on asthma control in adult patients. We hypothesized that patients would have fewer asthma exacerbations after treatment with an SSRI or SNRI. Methods: Electronic health record data of adult patients (N = 592) who were seen at a University of Texas Southwestern (UTSW) hospital or clinic and had (1) an SSRI or SNRI prescription, (2) a previous asthma diagnosis, and (3) no mood disorder diagnosis were extracted by using the UTSW Clinical Data Exchange Network. Wilcoxon signed rank tests were used to compare oral corticosteroid prescriptions and asthma-related emergency department (ED) visits and hospitalizations in the 12 months before and after the start of an SSRI/SNRI. Results: Therapy with SSRIs/SNRIs was associated with a significant decrease in oral corticosteroid use (p = 0.003), ED visits (p = 0.002), and hospitalizations (p < 0.001). Conclusion: Results from the current study add to the existing literature by demonstrating a reduced rate of severe exacerbations in patients with asthma by using an SSRI/SNRI without limiting the analytic sample to a high-illness-severity subgroup defined by symptoms of asthma or depression. Future work should include a prospective, placebo controlled study with individuals who have asthma and no comorbid mental health condition, verified by a mental health professional.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Asthma* / diagnosis
  • Asthma* / drug therapy
  • Asthma* / epidemiology
  • Depressive Disorder, Major* / drug therapy
  • Depressive Disorder, Major* / epidemiology
  • Humans
  • Norepinephrine
  • Prospective Studies
  • Retrospective Studies
  • Selective Serotonin Reuptake Inhibitors / adverse effects
  • Serotonin and Noradrenaline Reuptake Inhibitors*

Substances

  • Selective Serotonin Reuptake Inhibitors
  • Serotonin and Noradrenaline Reuptake Inhibitors
  • Norepinephrine