Newer Antidepressants Not Associated With CV Risk

A new study found that selective serotonin reuptake inhibitors (SSRIs) are not associated with an increased risk of cardiovascular events in adults with depression.

Previous studies have shown that depression increases the risk of cardiovascular outcomes, but whether the use of antidepressants, particularly SSRIs, increases or reduces this risk has been the subject of controversy.

In a cohort study conducted by Carole Coupland and colleagues in the UK, health records of 238,963 adult patients initially diagnosed with depression between January 1, 2000 and July 31, 2011 were evaluated. After 5 years of follow-up, 209,476 patients (87.7%) had received a total of 3,337,336 antidepressant prescriptions; 71.3% of patients were prescribed SSRIs.

Compared with periods of no antidepressant treatment, there were no significant associations between any of the antidepressant classes studied and arrhythmia, myocardial infarction, or stroke or transient ischemic attack over 5 years of follow-up. In fact, risk of arrhythmia was slightly reduced while taking SSRIs compared with periods of not taking antidepressants (aHR, 0.84; 95% CI, 0.73–0.97). Individually, risk of myocardial infarction was significantly reduced with fluoxetine (aHR, 0.44; 95% CI, 0.27–0.72) and was slightly increased with lofepramine (aHR, 3.07; 95% CI, 1.50 to 6.26).

The results of this large, population-based cohort study indicate that SSRIs are not associated with an increase risk of cardiovascular events in adults aged 20 to 64 years. “These findings are reassuring in light of recent safety concerns about [SSRIs],” the authors concluded.

Reference

Coupland C, Hill T, Morriss R, et al. Antidepressant use and risk of cardiovascular outcomes in people aged 20 to 64: cohort study using primary care database. BMJ. 2016;352:i1350.