Antidepressants Tied to a Significantly Increased Risk for Death

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By Megan Brooks

Use of antidepressants is associated with an increased risk for death in the general population, but not in patients with existing cardiovascular disease, results of a meta-analysis suggest.

The results support the hypothesis that antidepressants are harmful in the general population but are less so in cardiovascular patients, perhaps owing to their blood thinning effects, investigators note.

"The common wisdom is that antidepressants are safe and effective, and by treating people with depression with antidepressants, we can save lives. However, research over the last decade has shown that antidepressants are much less effective than we had thought. Our research is part of a body of research that suggests that antidepressants are much less safe than we had thought," lead researcher Paul W. Andrews, PhD, JD, of the Department of Psychology, Neuroscience and Behavior, McMaster University, Hamilton, Ontario, Canada, told Medscape Medical News.

The study was published online September 14 in Psychotherapy and Psychosomatics.

Similar Risk With Tricyclics, SSRIs

The investigators assessed the effects of antidepressants on all-cause mortality and cardiovascular events in general-population and cardiovascular-patient samples in a meta-analysis that included 17 relevant studies.

"Sample type consistently moderated health risks," the authors report.

In general-population samples, antidepressant use increased the risk for death from any cause by 33% (hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.14 - 1.55) and the risk for new cardiovascular events by 14% (HR, 1.14; 95% CI, 1.08 - 1.21).

Conversely, in patients with preexisting cardiovascular disease, antidepressant use was associated with a nonsignificant decrease in all-cause mortality (HR, 0.90; 95% CI, 0.76 - 1.07) and cardiovascular events (HR, 0.93; 95% CI, 0.82 - 1.06).

The anticlotting properties of antidepressants "may facilitate blood flow to the heart when blood vessels are blocked or constricted, decreasing the likelihood of cardiovascular events in samples exhibiting these types of pathologies, and thereby offsetting the negative effects of antidepressants," the investigators write.

Source: Medscape News

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