ArticleJAMA network open2022
Risk of Opioid Overdose Associated With Concomitant Use of Oxycodone and Selective Serotonin Reuptake Inhibitors.
Article in JAMA network open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05730062 (Influence of Oxycodone on Individuals Taking an SSRI), which is not on this map. Cited by 14 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Influence of Oxycodone on Individuals Taking an SSRI
Who cites it
14 citing papers in PubMed, 21 citations in OpenAlex.
- Effect of Paroxetine or Escitalopram Coadministered with Oxycodone versus Oxycodone Alone on Ventilation during Hypercapnia: A Randomized Clinical Trial.Anesthesiology · 2026Trial
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- Opioid Toxicity Following Concomitant Use of Macrolide Antibiotics with Fentanyl, Hydromorphone, or Oxycodone: A Population-Based Study.Clinical pharmacology and therapeutics · 2026Article
- Risk of opioid overdose associated with concurrent use of hydrocodone and CYP3A4-inhibiting calcium channel blockers: a population-based cohort study.American journal of epidemiology · 2025Article
- Opioid overdose associated with concomitant use of hydrocodone and selective serotonin reuptake inhibitors.BMC medicine · 2025Article
- Regional and Temporal Variation in Receipt of Gabapentinoid and SSRI/SNRI Therapy Among Older Cancer Survivors in the United States.Current oncology (Toronto, Ont.) · 2025Article
- Psychiatric Comorbidity Does Not Enhance Prescription Opioid Use in Inflammatory Bowel Disease as It Does in the General Population.Inflammatory bowel diseases · 2025Article
- Evaluation of Drug-Drug Interactions in Pharmacoepidemiologic Research.Pharmacoepidemiology and drug safety · 2025Review
- Clinical and Adverse Outcomes Associated With Concomitant Use of CYP2D6-Metabolized Opioids With Antidepressants in Older Nursing Home Residents : A Target Trial Emulation Study.Annals of internal medicine · 2024Article
- Concomitant Use of Sodium-Glucose Cotransporter 2 Inhibitors and Overactive Bladder Drugs and the Risk of Urinary Tract Infection.Clinical pharmacology and therapeutics · 2024Article
- Co-prescribing of Central Nervous System-Active Medications for COPD Patients: Impact on Emergency Room Visits and Hospitalization.The Annals of pharmacotherapy · 2023Article
- Safety implications of concomitant administration of antidepressants and opioid analgesics in surgical patients.Expert opinion on drug safetyObservational
- Association of Socioeconomic and Psychiatric Factors with Postoperative Opioid Use Disorder: A Retrospective Cohort Analysis.Substance use : research and treatmentArticle
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
Importance: Some selective serotonin reuptake inhibitors (SSRIs) inhibit the enzymes responsible for the metabolism of oxycodone, a potent prescription opioid. The clinical consequences of this interaction on the risk of opioid overdose have not been elucidated. Objective: To compare opioid overdose rates in patients initiating oxycodone while taking SSRIs that are potent inhibitors of the cytochrome-P450 2D6 enzyme (CYP2D6) vs SSRIs that are not. Design, Setting, and Participants: This cohort study included adults who initiated oxycodone while receiving SSRI therapy between 2000 and 2020 whose data were included in 3 US health insurance databases. Exposures: Use of SSRIs that strongly inhibit CYP2D6 enzyme (fluoxetine or paroxetine) vs use of other SSRIs at the time of oxycodone initiation. Main Outcomes and Measures: Opioid overdose hospitalization or emergency department visit. Outcomes were assessed within 365 days of oxycodone initiation; in primary analyses, patients were followed up until the discontinuation of either oxycodone or their index SSRI group. Propensity score matching weights were used to adjust for confounding. Crude and weighted (adjusted) incidence rates and hazard ratios were estimated using Cox regression models, separately within each database and overall, stratifying on database. Results: A total of 2 037 490 initiated oxycodone while taking SSRIs (1 475 114 [72.4%] women; mean [SD] age, 50.1 [15.3] years). Most (1 418 712 [69.6%]) were receiving other SSRIs at the time of oxycodone initiation. In the primary analysis, we observed 1035 overdose events (0.05% of the study cohort). The adjusted incidence rate of opioid overdose in those using inhibiting SSRIs at the time of oxycodone initiation (9.47 per 1000 person-years) was higher than in those using other SSRIs (7.66 per 1000 person-years), indicating a greater risk of overdose among patients using CYP2D6-inhibiting SSRIs (adjusted hazard ratio, 1.23; 95% CI, 1.06-1.31). Results were consistent across multiple subgroup and sensitivity analyses. Conclusions and Relevance: In this cohort study of US adults, initiating oxycodone in patients treated with paroxetine or fluoxetine was associated with a small increased risk of opioid overdose.
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