Death Risk Significantly Elevated for Some Patients Taking Antidepressants

Antidepressants increase the risk for mortality among individuals without cardiovascular disease, according to the findings of a recent meta-analysis. However, individuals with cardiovascular disease were not affected by antidepressant use.

While antidepressants are known to disrupt multiple adaptive processes that could potentially increase the risk for mortality, they are known to have anticlotting properties that might effectively treat cardiovascular disease.
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In their meta-analysis, the researcher searched for articles from PudMed, Embase, and Google Scholar that included antidepressant-related mortality and controlled for depression and other comorbidities. Seventeen studies were identified and the sample type consistently moderated health risk. The researchers extracted data on the cardiovascular risk status of participants, cardiovascular events, and antidepressant class.

Their findings showed that antidepressant use was associated with an increased risk of mortality among samples from the general population (hazard ratio [HR]1.33). However, AD use did not significantly affect patients with cardiovascular disease.

Mortality was moderated by antidepressant class. Although, serotonin reuptake inhibitors were not significantly different from tricyclic antidepressants (HR 1.10). Only antidepressants classified as “other” were differentiable from tricyclic antidepressants (HR 1.35).

In addition, analysis of studies that controlled for premedication depression showed mortality risk estimates increase. This suggested the absence of confounding by indication, the researchers wrote.

 “The results support the hypothesis that [antidepressants] are harmful in the general population but less harmful in cardiovascular patients,” the researchers concluded.

—Melissa Weiss

Reference:

Maslej MM, Bolker BM, Russell MJ, et al. The mortality and myocardial effects of antidepressants are moderated by preexisting cardiovascular disease: a meta-analysis [published online September 14, 2017]. Psychother Psychosom. https://doi.org/10.1159/000477940.