The incidence and severity of Clostridioides difficile infection (CDI) have risen in North America, the United Kingdom, and Europe. Limited evidence in the literature suggests a connection between CDI and antidepressant medication usage.

In his recent research, Antoine Boustany from Cleveland Clinic said, the use of mirtazapine, nortriptyline, or trazodone antidepressants increases the likelihood of contracting a CDI. The prevalence rate of this infection in patients who were using antidepressant medications and the ones who did not, increase with age

CDI is the most common cause of antibiotic-associated diarrhoea. Several risk factors have been implicated. In this study, researchers investigated whether the risk of developing CDI is increased in hospitalised patients using antidepressant medications.
The study included hospitalised patients and excluded those less than 18 years old. A multivariate regression analysis was performed to calculate the risk of CDI accounting for potential confounders.
Key insights from this research article are:
CDI patients had female predilection.
Patients with CDI had type 2 diabetes, inflammatory bowel disease, irritable bowel syndrome, smoking and alcohol use more common.
The risk of CDI was no longer increased in patients using fluoxetine with OR, 0.94.
The risk of CDI was more significant in those with inflammatory bowel disease patients using clindamycin, beta-lactam antibiotics, PPI, Trazadone, nortriptyline and mirtazapine.
They said, “This is the most extensive investigation to date that examines the risk of developing CDI in hospitalised patients who use antidepressant medications. Our findings reinforce the limited evidence present in the literature."
Reference:
Boustany, Antoine & Onwuzo, Somtochukwu & Abou Zeid, Hadi & Almomani, Ashraf & ASAAD, Imad. (2023). ANTIDEPRESSANT MEDICATIONS ARE ASSOCIATED WITH INCREASED RISK OF HOSPITAL-ACQUIRED CLOSTRIDIOIDES DIFFICILE INFECTION: A POPULATION-BASED STUDY. Arquivos de Gastroenterologia. 60. 309-314. 10.1590/s0004-2803.230302023-21.