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RESEARCH ARTICLE
Abstract
Background
Bupropion, which is widely used in patients with depressive disorder, may cause allergic reactions. However, the real prevalence of these side effects may be overlooked and underreported due to the delayed onset phenomenon.
Objective
This study aimed to estimate the real incidence of bupropion-induced urticaria and clarify the delayed onset phenomenon.
Methods
We conducted a nationwide cohort study between 2000 and 2009 using Taiwan’s National Health Insurance Dataset. Among 65,988 patients with depressive disorders, we identified new users of bupropion with depressive disorders (bupropion cohort, n = 2,839) and matched them at a ratio of 1:4 regarding age and sex (non-bupropion matched cohort, n = 11,356). The risk of urticaria was compared between the two cohorts.
Results
The risk of urticaria occurrence was higher in bupropion users than in matched controls within 4 weeks of starting the medication (risk ratio 1.81; 95% confidence interval 1.28–2.54; p = 0.001). The occurrence of urticaria in the bupropion cohort were more frequent on Days 15–28 than Day 1–14 (p = 0.002). Cox proportional hazards model showed that a history of urticaria was an independent risk factor for developing bupropion-induced urticaria.
Conclusions
Of the antidepressants, bupropion may pose a higher risk of drug-induced urticaria, and this condition might be ignored due to the delayed onset phenomenon. Depressive patients with a history of urticaria are at higher risk of the adverse drug reaction. This study emphasizes the need for increased clinical awareness of this adverse outcome to bupropion use.
Figures
Citation: Hu L-Y, Liu C-J, Lu T, Hu T-M, Tsai C-F, et al. (2013) Delayed Onset Urticaria in Depressive Patients with Bupropion Prescription: A Nationwide Population-Based Study. PLoS ONE 8(11): e80064. doi:10.1371/journal.pone.0080064
Editor: James M Wright, University of British Columbia, Canada
Received: May 14, 2013; Accepted: October 8, 2013; Published: November 14, 2013
Copyright: © 2013 Hu et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This study was supported by grants from Taipei Veterans General Hospital (V102D-001-1 and V102D-001-2) and Yuli Veterans Hospital (VHYL-102-08). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist
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