Association of Megestrol Use With the Development of New Psychiatric Diagnoses

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Objective

To analyze the risk of megestrol, a glucocorticoid and progesterone receptor agonist
used to enhance appetite, on the development of a new psychiatric diagnosis.

Design and Participants

Deidentified data of megestrol (n = 706) and propensity score-matched comparison (age,
gender, and body mass index) patients (n = 2,118) from January 1, 2001 to June 30,
2018 were obtained from the UT Southwestern patient database. Data were analyzed using
a series of conditional binary logistic regressions controlling for comorbidities,
pre-existing psychiatric disorders, and number of patient encounters.

Setting

A large academic medical center database of megestrol-treated patients and matched
comparison patients was used.

Measurements and Results

The regression model showed that megestrol was significantly associated with developing
a new psychiatric diagnosis (B = 1.28, Wald χ
21 = 83.12, odds ratio [OR] = 3.60, p <0.001). In subgroup analyses, development of
cognitive (B = 2.42, Wald χ
21 = 16.09, OR = 11.30, p <0.001), mood (B = 1.31, Wald χ
21 = 40.38, OR = 3.70, p <0.001), and anxiety (B = 1.72, Wald χ
21 = 45.28, OR = 5.60, p <0.001) disorders were also associated with megestrol use.

Conclusions

Patients taking megestrol were significantly more likely to develop a new psychiatric
diagnosis than comparison patients. Highest risks were associated with the development
of cognitive diagnoses. The findings suggest that megestrol, like other glucocorticoid
agonists, is associated with an increased risk of developing a psychiatric disorder.
This risk should be considered when determining the risk-to-benefit ratio of megestrol
use in patients.

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