Long-term antidepressant use may increase risk of sudden cardiac death
Long-term antidepressant use may increase a person’s risk of sudden cardiac death (SCD), according to new findings published in Heart Rhythm.[1]
“SCD frequently occurs without warning, often in individuals without previously diagnosed cardiovascular disease,” wrote first author Jasmin Mujkanovic, MD, a cardiologist with Copenhagen University Hospital, and colleagues. “It accounts for a significant proportion of cardiovascular mortality worldwide. Psychiatric disorders have previously been shown to be associated with SCD, with major depressive disorders having a twofold increased risk … Pharmacologic treatment of depression, with antidepressants among the most common pharmaceuticals prescribed, adds another layer of complexity.”
To learn more, Mujkanovic et al. explored data from more than 4 million Danish adults. All deaths in Denmark in 2010 were “thoroughly and manually reviewed” to ensure all cases of SCD were identified and cataloged.
Out of 6,002 SCD deaths, 32% occurred in antidepressant users. Adjusted hazard ratios were 1.41 for one to five years of antidepressant use and 1.74 for six or more years of antidepressant use. Current antidepressant users faced the highest risk of SCD, followed by recent users and then remote users.
The group did emphasize that these data do not prove antidepressants directly caused SCD in these patients. Further research is still necessary before any claims about causality can be made.
“Our findings suggest that prolonged treatment with ADs is associated with an elevated risk of SCD, a risk that is observed even when adjusting for comorbidities and when examining subclass drugs such as selective serotonin reuptake inhibitors or tricyclic antidepressants,” the authors wrote. “There seems to be a time-dependent factor, given that remote use showed a reduced risk compared with current use. However, separating potential effects of AD treatment from the severity and course of the underlying psychiatric disorder remains challenging in observational data, and residual confounding cannot be excluded.”
Read the team’s full analysis in Heart Rhythm, a Heart Rhythm Society journal, here.
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.