Which antidepressants increase the risk for Clostridium difficile (C diff) infection (CDI)?

Updated: Jul 25, 2019
  • Author: Faten N Aberra, MD, MSCE; Chief Editor: BS Anand, MD  more...
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Two related studies documented an increased risk of CDI in adults taking the antidepressants mirtazapine and fluoxetine. [17, 18] In a longitudinal study of 16,781 older adults (mean age, 67.9 y), 404 of whom had been diagnosed with CDI at least once, major depression was associated with a 36% increase in the odds of developing an infection with C difficile.

In the second study, in which 4047 adult patients had their stools tested for C difficile while they were hospitalized, the odds of testing positive for the bacterium were twice as high in patients who received mirtazapine or fluoxetine as in those who did not. [17, 18] None of the other 10 antidepressants that were tested in the study increased the risk of CDI.

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