Abstract
Objectives
The aim of this study was to investigate the relationship between zolpidem use and the risk of acute pancreatitis in Taiwan.
Methods
In this population-based case-control study using the database from the Taiwan National Health Insurance Program from 2000 to 2011, we selected 4535 subjects aged 20–84 years with the first episode of acute pancreatitis as cases and 18,140 subjects without acute pancreatitis matched for sex, age, and index year as controls. Immediate use of zolpidem was defined as subjects who received at least one prescription for zolpidem within 7 days before the date of diagnosing acute pancreatitis. The absence of zolpidem prescription was defined as never use. The odds ratio (OR) and 95 % confidence interval (CI) were used to evaluate the risk of acute pancreatitis associated with zolpidem use and other comorbidities.
Results
After adjustment for confounding factors, the multivariable logistic regression model demonstrated that the adjusted OR of acute pancreatitis was 7.20 for immediate use of zolpidem (95 % CI 5.81, 8.92), when compared to those with never use of zolpidem. In further analysis, as a reference of subjects with never use of zolpidem and without any of these comorbidities including alcoholism, biliary stone, diabetes mellitus, hepatitis B, hepatitis C, and hypertriglyceridemia, the adjusted OR was 18.04 in those with immediate use of zolpidem and without any comorbidity (95 % CI 12.71, 25.60). The OR increased to 30.32 in subjects with immediate use of zolpidem and with any comorbidity (95 % CI 23.71, 38.79).
Conclusions
Patients actively using zolpidem are at 7-fold increased odds of acute pancreatitis. Clinicians should be more cautious of acute pancreatitis risk among patients with any comorbidity studied when prescribing zolpidem.
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Funding
This study was supported in part by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW103-TDU-B-212-113002). The funding agency did not influence the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Author contributions
Shih-Wei Lai had substantial contributions to the conception of this article. He planned and conducted the study. He initiated the draft of the article and critically revised the article. Cheng-Li Lin conducted the data analysis and critically revised the article. Kuan-Fu Liao planned and conducted the study. He participated in the data interpretation and also critically revised the article.
Conflict of interest
The authors disclose no conflicts of interest.
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Lai, SW., Lin, CL. & Liao, KF. Increased relative risk of acute pancreatitis in zolpidem users. Psychopharmacology 232, 2043–2048 (2015). https://doi.org/10.1007/s00213-014-3833-6
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DOI: https://doi.org/10.1007/s00213-014-3833-6