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Neuropathic Pain

Rebecca M Joseph, Ruth H Jack, Richard Morriss, Roger David Knaggs, Debbie Buttler, Chris Hollis, Julia Hippisley-Cox, Carrol Coupland

Type
Disease or Syndrome
ID
PH868
Version ID
1815
Data Sources
Valid event data range
01/01/2005 - 30/11/2018
Sex
Female, Male
Agreement Date
2022-02-02
Coding system
Read codes v2
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Background:

Studies have reported an increased risk of mortality among people prescribed mirtazapine compared to other antidepressants. The study aimed to compare all-cause and cause-specific mortality between adults prescribed mirtazapine or other second-line antidepressants.

Methods:

This cohort study used English primary care electronic medical records, hospital admission records, and mortality data from the Clinical Practice Research Datalink (CPRD), for the period 01 January 2005 to 30 November 2018. It included people aged 18–99 years with depression first prescribed a selective serotonin reuptake inhibitor (SSRI) and then prescribed mirtazapine (5081), a different SSRI (15,032), amitriptyline (3905), or venlafaxine (1580). Follow-up was from starting to stopping the second antidepressant, with a 6-month wash-out window, censoring at the end of CPRD follow-up or 30 November 2018. Age-sex standardised rates of all-cause mortality and death due to circulatory system disease, cancer, or respiratory system disease were calculated. Survival analyses were performed, accounting for baseline characteristics using inverse probability of treatment weighting.

Results:

The cohort contained 25,598 people (median age 41 years). The mirtazapine group had the highest standardised mortality rate, with an additional 7.8 (95% confidence interval (CI) 5.9–9.7) deaths/1000 person-years compared to the SSRI group. Within 2 years of follow-up, the risk of all-cause mortality was statistically significantly higher in the mirtazapine group than in the SSRI group (weighted hazard ratio (HR) 1.62, 95% CI 1.28–2.06). No significant difference was found between the mirtazapine group and the amitriptyline (HR 1.18, 95% CI 0.85–1.63) or venlafaxine (HR 1.11, 95% CI 0.60–2.05) groups. After 2 years, the risk was significantly higher in the mirtazapine group compared to the SSRI (HR 1.51, 95% CI 1.04–2.19), amitriptyline (HR 2.59, 95% CI 1.38–4.86), and venlafaxine (HR 2.35, 95% CI 1.02–5.44) groups. The risks of death due to cancer (HR 1.74, 95% CI 1.06–2.85) and respiratory system disease (HR 1.72, 95% CI 1.07–2.77) were significantly higher in the mirtazapine than in the SSRI group.

Conclusions:

Mortality was higher in people prescribed mirtazapine than people prescribed a second SSRI, possibly reflecting residual differences in other risk factors between the groups. Identifying these potential health risks when prescribing mirtazapine may help reduce the risk of mortality.

Publications

  • Rebecca M Joseph, Ruth H Jack, Richard Morriss, Roger David Knaggs, Debbie Buttler, Chris Hollis, Julia Hippisley-Cox, Carrol Coupland, The risk of all-cause and cause-specific mortality in people prescribed mirtazapine an active comparator cohort study using electronic health records. BMC Medicine, 20(43), 2022.

Clinical Code List

Rows: 156
Code Description Entity type Category Coding System (Read)
1475 h/o: trigeminal neuralgia res176: Neuropathic pain diagnostic Read
1DC1.00 burning pain res176: Neuropathic pain diagnostic Read
1DC9.00 shooting pain res176: Neuropathic pain diagnostic Read
1M4..00 central post-stroke pain res176: Neuropathic pain diagnostic Read
1M8..00 diabetic peripheral neuropathic pain res176: Neuropathic pain diagnostic Read
A531.11 post-herpetic neuralgia res176: Neuropathic pain diagnostic Read
A531200 postherpetic trigeminal neuralgia res176: Neuropathic pain diagnostic Read
A531300 postherpetic polyneuropathy res176: Neuropathic pain diagnostic Read
A531500 postzoster neuralgia res176: Neuropathic pain diagnostic Read
A531511 postherpetic neuralgia res176: Neuropathic pain diagnostic Read
A72x100 mumps polyneuropathy res176: Neuropathic pain diagnostic Read
C106.12 diabetes mellitus with neuropathy res176: Neuropathic pain diagnostic Read
C106.13 diabetes mellitus with polyneuropathy res176: Neuropathic pain diagnostic Read
C108B00 insulin dependent diabetes mellitus with mononeuropathy res176: Neuropathic pain diagnostic Read
C108B11 type i diabetes mellitus with mononeuropathy res176: Neuropathic pain diagnostic Read
C108C00 insulin dependent diabetes mellitus with polyneuropathy res176: Neuropathic pain diagnostic Read
C108J00 insulin dependent diab mell with neuropathic arthropathy res176: Neuropathic pain diagnostic Read
C108J11 type i diabetes mellitus with neuropathic arthropathy res176: Neuropathic pain diagnostic Read
C108J12 type 1 diabetes mellitus with neuropathic arthropathy res176: Neuropathic pain diagnostic Read
C109A00 non-insulin dependent diabetes mellitus with mononeuropathy res176: Neuropathic pain diagnostic Read
C109A11 type ii diabetes mellitus with mononeuropathy res176: Neuropathic pain diagnostic Read
C109B00 non-insulin dependent diabetes mellitus with polyneuropathy res176: Neuropathic pain diagnostic Read
C109B11 type ii diabetes mellitus with polyneuropathy res176: Neuropathic pain diagnostic Read
C109B12 type 2 diabetes mellitus with polyneuropathy res176: Neuropathic pain diagnostic Read
C109H00 non-insulin dependent d m with neuropathic arthropathy res176: Neuropathic pain diagnostic Read
C109H11 type ii diabetes mellitus with neuropathic arthropathy res176: Neuropathic pain diagnostic Read
C109H12 type 2 diabetes mellitus with neuropathic arthropathy res176: Neuropathic pain diagnostic Read
C10EB00 type 1 diabetes mellitus with mononeuropathy res176: Neuropathic pain diagnostic Read
C10EC00 type 1 diabetes mellitus with polyneuropathy res176: Neuropathic pain diagnostic Read
C10EC11 type i diabetes mellitus with polyneuropathy res176: Neuropathic pain diagnostic Read
C10EC12 insulin dependent diabetes mellitus with polyneuropathy res176: Neuropathic pain diagnostic Read
C10EJ00 type 1 diabetes mellitus with neuropathic arthropathy res176: Neuropathic pain diagnostic Read
C10FA00 type 2 diabetes mellitus with mononeuropathy res176: Neuropathic pain diagnostic Read
C10FA11 type ii diabetes mellitus with mononeuropathy res176: Neuropathic pain diagnostic Read
C10FB00 type 2 diabetes mellitus with polyneuropathy res176: Neuropathic pain diagnostic Read
C10FB11 type ii diabetes mellitus with polyneuropathy res176: Neuropathic pain diagnostic Read
C10FH00 type 2 diabetes mellitus with neuropathic arthropathy res176: Neuropathic pain diagnostic Read
C10FH11 type ii diabetes mellitus with neuropathic arthropathy res176: Neuropathic pain diagnostic Read
C373200 familial neuropathic amyloid res176: Neuropathic pain diagnostic Read
C373K13 familial amyloid polyneuropathy type iii res176: Neuropathic pain diagnostic Read
F170.00 idiopathic peripheral autonomic neuropathy res176: Neuropathic pain diagnostic Read
F170z00 idiopathic peripheral autonomic neuropathy nos res176: Neuropathic pain diagnostic Read
F171.00 peripheral autonomic neuropathy disease ec res176: Neuropathic pain diagnostic Read
F171000 autonomic neuropathy due to amyloid res176: Neuropathic pain diagnostic Read
F171100 autonomic neuropathy due to diabetes res176: Neuropathic pain diagnostic Read
F171z00 peripheral autonomic neuropathy due to disease nos res176: Neuropathic pain diagnostic Read
F262100 horton's (histamine) neuralgia res176: Neuropathic pain diagnostic Read
F262500 periodic migrainous neuralgia res176: Neuropathic pain diagnostic Read
F262C00 shortlast unilat neuralgifrm pain+conjunc inject+tearng synd res176: Neuropathic pain diagnostic Read
F300.00 post-herpetic trigeminal neuralgia res176: Neuropathic pain diagnostic Read
F301.00 other specified trigeminal neuralgia res176: Neuropathic pain diagnostic Read
F301000 tic douloureux res176: Neuropathic pain diagnostic Read
F301z00 trigeminal neuralgia nos res176: Neuropathic pain diagnostic Read
F321.00 glossopharyngeal neuralgia res176: Neuropathic pain diagnostic Read
F335.00 neuralgic amyotrophy res176: Neuropathic pain diagnostic Read
F336000 phantom limb syndrome with pain res176: Neuropathic pain diagnostic Read
F342400 ulnar neuropathy res176: Neuropathic pain diagnostic Read
F347.00 complex regional pain syndrome type ii res176: Neuropathic pain diagnostic Read
F351.00 meralgia paraesthetica res176: Neuropathic pain diagnostic Read
F356100 morton's neuralgia res176: Neuropathic pain diagnostic Read
F36..00 hereditary and idiopathic peripheral neuropathy res176: Neuropathic pain diagnostic Read
F360.00 hereditary peripheral neuropathy res176: Neuropathic pain diagnostic Read
F360z00 hereditary peripheral neuropathy nos res176: Neuropathic pain diagnostic Read
F362.00 hereditary sensory neuropathy res176: Neuropathic pain diagnostic Read
F364.00 idiopathic progressive polyneuropathy res176: Neuropathic pain diagnostic Read
F365.00 neuropathy in association with hereditary ataxia res176: Neuropathic pain diagnostic Read
F366.00 polyneuropathy res176: Neuropathic pain diagnostic Read
F367.00 peripheral neuropathy res176: Neuropathic pain diagnostic Read
F368.00 hereditary motor and sensory neuropathy res176: Neuropathic pain diagnostic Read
F368000 hereditary motor and sensory neuropathy type i res176: Neuropathic pain diagnostic Read
F368100 hereditary motor and sensory neuropathy type ii res176: Neuropathic pain diagnostic Read
F368200 hereditary motor and sensory neuropathy type iii res176: Neuropathic pain diagnostic Read
F369.00 complex regional pain syndrome res176: Neuropathic pain diagnostic Read
F369.11 chronic regional pain syndrome res176: Neuropathic pain diagnostic Read
F36y.00 other idiopathic peripheral neuropathy res176: Neuropathic pain diagnostic Read
F36yz00 other idiopathic peripheral neuropathy nos res176: Neuropathic pain diagnostic Read
F36z.00 hereditary or idiopathic peripheral neuropathy nos res176: Neuropathic pain diagnostic Read
F37..00 inflammatory and toxic neuropathy res176: Neuropathic pain diagnostic Read
F37..11 toxic neuropathy res176: Neuropathic pain diagnostic Read
F371.00 polyneuropathy in collagen vascular disease res176: Neuropathic pain diagnostic Read
F371000 polyneuropathy in disseminated lupus erythematosus res176: Neuropathic pain diagnostic Read
F371100 polyneuropathy in polyarteritis nodosa res176: Neuropathic pain diagnostic Read
F371z00 polyneuropathy in collagen vascular disease nos res176: Neuropathic pain diagnostic Read
F372.00 polyneuropathy in diabetes res176: Neuropathic pain diagnostic Read
F372.11 diabetic polyneuropathy res176: Neuropathic pain diagnostic Read
F372.12 diabetic neuropathy res176: Neuropathic pain diagnostic Read
F372000 acute painful diabetic neuropathy res176: Neuropathic pain diagnostic Read
F372100 chronic painful diabetic neuropathy res176: Neuropathic pain diagnostic Read
F373.00 polyneuropathy in malignant disease res176: Neuropathic pain diagnostic Read
F374000 polyneuropathy in amyloidosis res176: Neuropathic pain diagnostic Read
F374100 polyneuropathy in beriberi res176: Neuropathic pain diagnostic Read
F374200 polyneuropathy in vitamin b deficiency res176: Neuropathic pain diagnostic Read
F374300 polyneuropathy in diphtheria res176: Neuropathic pain diagnostic Read
F374400 polyneuropathy in herpes zoster res176: Neuropathic pain diagnostic Read
F374500 polyneuropathy in hypoglycaemia res176: Neuropathic pain diagnostic Read
F374600 polyneuropathy in mumps res176: Neuropathic pain diagnostic Read
F374800 polyneuropathy in porphyria res176: Neuropathic pain diagnostic Read
F374900 polyneuropathy in sarcoidosis res176: Neuropathic pain diagnostic Read
F374A00 polyneuropathy in uraemia res176: Neuropathic pain diagnostic Read
F375.00 alcoholic polyneuropathy res176: Neuropathic pain diagnostic Read
F376.00 polyneuropathy due to drugs res176: Neuropathic pain diagnostic Read
F377.00 other toxic agent polyneuropathy res176: Neuropathic pain diagnostic Read
F37y.00 other toxic or inflammatory neuropathy res176: Neuropathic pain diagnostic Read
F3y0.00 diabetic mononeuropathy res176: Neuropathic pain diagnostic Read
Fyu1300 [x]paraneoplastic neuromyopathy and neuropathy res176: Neuropathic pain diagnostic Read
Fyu6A00 [x]other mononeuropathies of upper limb res176: Neuropathic pain diagnostic Read
Fyu6B00 [x]other mononeuropathies of lower limb res176: Neuropathic pain diagnostic Read
Fyu6C00 [x]other specified mononeuropathies res176: Neuropathic pain diagnostic Read
Fyu6D00 [x]other mononeuropathies in diseases classified elsewhere res176: Neuropathic pain diagnostic Read
Fyu7.00 [x]polyneuropathies & other disord of peripheral nerv syst res176: Neuropathic pain diagnostic Read
Fyu7000 [x]other hereditary and idiopathic neuropathies res176: Neuropathic pain diagnostic Read
Fyu7200 [x]other specified polyneuropathies res176: Neuropathic pain diagnostic Read
Fyu7500 [x]polyneuropathy/other endocrine+metabolic diseases ce res176: Neuropathic pain diagnostic Read
Fyu7800 [x]polyneuropathy/other musculoskeletal disorders ce res176: Neuropathic pain diagnostic Read
FyuAC00 [x]autonomic neuropathy/endocrine+metabolic diseases ce res176: Neuropathic pain diagnostic Read
M271100 neuropathic diabetic ulcer - foot res176: Neuropathic pain diagnostic Read
M271700 neuropathic foot ulcer res176: Neuropathic pain diagnostic Read
M2y1500 painful operation scar res176: Neuropathic pain diagnostic Read
N035.00 neuropathic arthropathy res176: Neuropathic pain diagnostic Read
N035.12 neuropathic arthritis res176: Neuropathic pain diagnostic Read
N119.00 cervical spondylosis with radiculopathy res176: Neuropathic pain diagnostic Read
N119000 single-level cervical spondylosis with radiculopathy res176: Neuropathic pain diagnostic Read
N119100 two-level cervical spondylosis with radiculopathy res176: Neuropathic pain diagnostic Read
N119200 multiple-level cervical spondylosis with radiculopathy res176: Neuropathic pain diagnostic Read
N11B.00 thoracic spondylosis with radiculopathy res176: Neuropathic pain diagnostic Read
N11B000 single-level thoracic spondylosis with radiculopathy res176: Neuropathic pain diagnostic Read
N11B100 two-level thoracic spondylosis with radiculopathy res176: Neuropathic pain diagnostic Read
N11B200 multiple-level thoracic spondylosis with radiculopathy res176: Neuropathic pain diagnostic Read
N11C.00 lumbosacral spondylosis with radiculopathy res176: Neuropathic pain diagnostic Read
N11C000 single-level lumbosacral spondylosis with radiculopathy res176: Neuropathic pain diagnostic Read
N11C100 two-level lumbosacral spondylosis with radiculopathy res176: Neuropathic pain diagnostic Read
N11C200 multiple-level lumbosacral spondylosis with radiculopathy res176: Neuropathic pain diagnostic Read
N11y200 neuropathic spondylopathy res176: Neuropathic pain diagnostic Read
N12C.00 disc prolapse with radiculopathy res176: Neuropathic pain diagnostic Read
N12C000 cervical disc prolapse with radiculopathy res176: Neuropathic pain diagnostic Read
N12C100 thoracic disc prolapse with radiculopathy res176: Neuropathic pain diagnostic Read
N12C200 lumbar disc prolapse with radiculopathy res176: Neuropathic pain diagnostic Read
N12C400 prolapsed lumbar intervertebral disc with sciatica res176: Neuropathic pain diagnostic Read
N12zH00 cervical disc disorder with radiculopathy res176: Neuropathic pain diagnostic Read
N142000 lumbago with sciatica res176: Neuropathic pain diagnostic Read
N143.00 sciatica res176: Neuropathic pain diagnostic Read
N143.11 acute back pain with sciatica res176: Neuropathic pain diagnostic Read
N242.00 neuralgia, neuritis and radiculitis unspecified res176: Neuropathic pain diagnostic Read
N242000 neuralgia unspecified res176: Neuropathic pain diagnostic Read
N242300 neuropathic pain res176: Neuropathic pain diagnostic Read
N242z00 neuralgia, neuritis or radiculitis nos res176: Neuropathic pain diagnostic Read
N337.12 reflex sympathetic dystrophy res176: Neuropathic pain diagnostic Read
N337111 reflex sympathetic dystrophy res176: Neuropathic pain diagnostic Read
N33C.00 complex regional pain syndrome type i res176: Neuropathic pain diagnostic Read
Nyu6300 [x]other spondylosis with radiculopathy res176: Neuropathic pain diagnostic Read
SD72200 neuropathic foot blister res176: Neuropathic pain diagnostic Read
SP07300 internal prosthetic device causing pain res176: Neuropathic pain diagnostic Read
SP07A00 pain due to hip joint prosthesis res176: Neuropathic pain diagnostic Read
SP07B00 pain due to knee joint prosthesis res176: Neuropathic pain diagnostic Read
SP07C00 pain due to shoulder joint prosthesis res176: Neuropathic pain diagnostic Read
SyuKE11 [x] pain due to internal orthopaedic prosthesis res176: Neuropathic pain diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH868/version/1815/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH868/version/1815/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH868', '1815', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH868/version/1815/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH868/version/1815/export/codes/?format=json
CSV site_root/phenotypes/PH868/version/1815/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH868', '1815', api_client=client)

Version History

Version
ID
Name Owner Publish date
1815 Neuropathic Pain ieuan.scanlon 2022-04-04 currently shown

Export - export all codes into a csv file/JSON/XML for the current phenotype version.

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