Association of Hydroxylmethyl Glutaryl Coenzyme A Reductase Inhibitors, L-Type Calcium Channel Antagonists, and Biguanides With Rates of Psychiatric Hospitalization and Self-Harm in Individuals With Serious Mental Illness

Abstract

Key Points Question Are drugs in common use for physical health problems (hydroxylmethyl glutaryl coenzyme A reductase inhibitors, L-type calcium channel antagonists, and biguanides) associated with reduced rates of psychiatric hospitalization and self-harm in individuals with serious mental illness? Findings In this series of within-individual cohort studies of 142 691 patients with bipolar disorder, schizophrenia, or nonaffective psychosis, exposure to any of the study drugs was associated with reduced rates of psychiatric hospitalizaiton compared with unexposed periods. Self-harm was reduced in patients with bipolar disorder and schizophrenia during exposure to all study drugs and in patients with nonaffective psychosis taking L-type calcium channel antagonists. Meaning Hydroxylmethyl glutaryl coenzyme A reductase inhibitors, L-type calcium channel antagonists, and biguanides hold potential as repurposed agents in serious mental illness, and the central nervous system mechanism of action of these drugs requires further investigation.

Rates of delirium associated with calcium channel blockers compared to diuretics, renin-angiotensin system agents and beta-blockers: An electronic health records network study

“…Some data suggest that, amongst AHT classes, calcium channel blockers (CCBs) and renin-angiotensin system (RAS) agents (angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II inhibitors (ARBs)) are more protective in this regard than are diuretics and beta-blockers ( Marpillat et al, 2013 ; Mukete et al, 2015 ; Mullapudi et al, 2016 ; Rouch et al, 2015 ; Zhuang et al, 2016 ). Less extensive data also report associations between CCB and RAS agent use with functional psychiatric disorders such as psychosis ( Hayes et al, 2019 ) and depression ( Boal et al, 2016 ).…”

Integrative Omics for Informed Drug Repurposing: Targeting CNS Disorders

“…Adjunct Therapy for Schizophrenia, Bipolar Disorder, and Non-Affective Psychosis [128] Mechanism of Action (MOA) was referenced from Drug Bank (https://www.drugbank.ca/). Original and repurposed indications were referenced from the cited study.…”

Voltage-gated calcium channel blockers for psychiatric disorders: genomic reappraisal

“…The extensive cardiovascular prescribing of CCBs allows for pharmacoepidemiological studies to assess whether their use is associated with an altered risk or course of neuropsychiatric disorders. Hayes et al 17 recently showed that, among patients with psychosis, rates of psychiatric admission and self-harm were 10–20% lower during periods of CCB treatment. The design rules out confounding by indication and no similar benefits were seen for thiazide diuretics or for non-psychiatric admissions, suggesting a degree of specificity.…”