{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:08:22Z","timestamp":1754093302810,"version":"3.41.2"},"reference-count":46,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec id=\"S2056472425100604_as1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Adults with mood and\/or anxiety disorders have increased risks of comorbidities, chronic treatments and polypharmacy, increasing the risk of drug\u2013drug interactions (DDIs) with antidepressants.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425100604_as2\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>To use primary care records from the UK Biobank to assess DDIs with citalopram, the most widely prescribed antidepressant in UK primary care.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425100604_as3\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>We classified drugs with pharmacokinetic or pharmacodynamic DDIs with citalopram, then identified prescription windows for these drugs that overlapped with citalopram prescriptions in UK Biobank participants with primary care records. We tested for associations of DDI status (yes\/no) with sociodemographic and clinical characteristics and with cytochrome 2C19 activity, using univariate tests, then fitted multivariable models for variables that reached Bonferroni-corrected significance.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425100604_as4\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>In UK Biobank primary care data, 25\u00a0508 participants received citalopram prescription(s), among which 11\u00a0941 (46.8%) had at least one DDI, with an average of 1.96 interacting drugs. The drugs most commonly involved were proton pump inhibitors (40% of co-prescription instances). Individuals with DDIs were more often female and older, had more severe and less treatment-responsive depression, and had higher rates of psychiatric and physical disorders. In the multivariable models, treatment resistance and markers of severity (e.g. history of suicidal and self-harm behaviours) were strongly associated with DDIs, as well as comorbidity with cardiovascular disorders. Cytochrome 2C19 activity was not associated with the occurrence of DDIs.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425100604_as5\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>The high frequency of DDIs with citalopram in fragile groups confirms the need for careful consideration before prescribing and periodic re-evaluation.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2025.10060","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T07:24:17Z","timestamp":1754033057000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with drug\u2013drug interactions involving citalopram in the UK Biobank"],"prefix":"10.1192","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2347-3735","authenticated-orcid":false,"given":"Benjamin","family":"Laplace","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Win Lee Edwin","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Menchetti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"De Ronchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Fusar-Poli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7930-563X","authenticated-orcid":false,"given":"Giuseppe","family":"Fanelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"MNESYS \u2013 Mood and Psychosis Sub-Project (Spoke 5)","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4363-3759","authenticated-orcid":false,"given":"Alessandro","family":"Serretti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8249-8476","authenticated-orcid":false,"given":"Cathryn M.","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0276-7865","authenticated-orcid":false,"given":"Chiara","family":"Fabbri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"key":"S2056472425100604_ref5","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afl023"},{"key":"S2056472425100604_ref3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-024051"},{"key":"S2056472425100604_ref12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0255192"},{"key":"S2056472425100604_ref1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.7507"},{"key":"S2056472425100604_ref21","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13435"},{"key":"S2056472425100604_ref26","doi-asserted-by":"publisher","DOI":"10.1177\/1060028013501994"},{"key":"S2056472425100604_ref36","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-015-0246-6"},{"key":"S2056472425100604_ref11","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S241780"},{"key":"S2056472425100604_ref41","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000000101"},{"key":"S2056472425100604_ref15","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-021-02594-z"},{"key":"S2056472425100604_ref38","doi-asserted-by":"publisher","DOI":"10.1002\/da.23135"},{"key":"S2056472425100604_ref22","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-021-01062-9"},{"key":"S2056472425100604_ref28","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12955"},{"key":"S2056472425100604_ref45","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1007\/s00228-021-03257-z","article-title":"Who gets prescriptions for proton pump inhibitors and why? 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