[Antidepressive agents and hypertension: A case/no-case study in French pharmacovigilance database]. / Antidépresseurs et hypertension artérielle : étude cas /non-cas dans la base nationale de pharmacovigilance.

INTRODUCTION: Drug-induced hypertension was described with several pharmacological classes. The association between hypertension and antidepressant drugs (AD) is controversial. The objective of this study was to evaluate the link between hypertension and ADs. MATERIALS AND METHODS: A retrospective disproportionality analysis from observations consecutively reported to the French pharmacovigilance database between 1985 and 2020 was performed. The relationship between the suspected ADs and the occurrence of hypertension was assessed by calculating the reporting odds ratio (ROR) in a case/non-case design. A negative (paracetamol) and a positive (celecoxib) control were used to validated this disproportionality method. RESULTS: We compared 6725 cases (including 464 AD-related cases) to 789,483 non-cases (including 56,440 AD-related cases). The reporting of hypertension was significantly associated with serotonin/norepinephrine reuptake inhibitors (SNRI) (ROR 1.43, 95 % CI 1.26-1.64) and monoamine oxidase inhibitors (MAOI) (ROR 6.41, 95 % CI 4.25-9.67) but not with other ADs classes. Concerning ADs analyzed independently of their AD class, a significant signal was observed with many SNRIs (duloxetin, milnacipran and venlafaxin) and with all MAOIs (moclobemide, iproniazide) (ROR between 2.04 and 17.93) but not with others ADs. The ROR value of positive (celecoxib) and negative (paracetamol) controls were ROR=1.53; IC95 %=1.04-2.26 and ROR=0.72; IC95 %=0.65-0.80, respectively. CONCLUSION: We found a significant association between development or worsening of hypertension and SNRIs and MAOIs but not with others ADs, in this study performed in real conditions of life. It is therefore advisable to remain cautious when prescribing ADs and to check systematically for hypertension.

Evaluation of a new training program to reassure primary school teachers about glucagon injection in children with type 1 diabetes during the 2017-2018 school year.

INTRODUCTION: The prevalence of type 1 diabetes (T1D) in children is increasing. Adequate knowledge and skills of primary school staff are required to deal with children affected by T1D. We aimed to evaluate a video training program (VTP) to improve the level of confidence of teachers in administering intramuscular glucagon injection during severe hypoglycemia. The secondary goal was to improve the teachers' theoretical knowledge. MATERIAL AND METHODS: In this interventional study, we submitted a VTP to all primary school teachers in the French region of Normandy who received a child with T1D during the 2017-2018 school year. The VTP began with a questionnaire focused on their confidence in performing T1D-related actions and on their theoretical knowledge. Next, we offered a 10-min video covering the main issues of T1D, which could be watched freely for a fortnight. The questionnaire was subsequently resubmitted. The level of confidence was assessed on a scale of 1 to 4. Knowledge was assessed as a score out of 20. Before-after comparisons were made using the Wilcoxon signed-rank test. Determinants of a good level of confidence and knowledge before VTP were assessed in the first questionnaires using multivariate analysis. RESULTS: Of 221 eligible teachers, 157 (71%) answered the first questionnaire and 77 (34.8%) answered both. The VTP significantly improved the teachers' confidence to administer a glucagon injection (+0.36 points, P<0.001). Their theoretical knowledge was also significantly improved (+1.5 points, P<0.001). CONCLUSIONS: We propose an original practical VTP that could be useful to improve teachers' T1D-related self-confidence in their skills and knowledge.