People who have used antidepressant for at least a year may have a higher risk of higher cardiac death — with some differences depending on the person’s age and biological sex.
- Sudden cardiac death (SCD) is responsible for about half of all
deaths caused by cardiovascular disease.
- Past studies show a link between some antidepressant medications to
a high risk of cardiovascular issues like SCD.
- A new study further confirms that antidepressant use may increase a
person’s risk for SCD, with differences between age groups and years of
medication use.
Past research shows
that sudden cardiac death (SCD)Trusted Source is
responsible for about half of all deathsTrusted Source caused
by cardiovascular disease.
SCD occurs when a person
experiencing sudden cardiac arrest (SCA) — where their heart suddenly
stops pumping — is not treated successfully, and usually happens within 1 hour
of disease symptoms occurring.
People with heart
disease are also at an increased
risk of developing depression, and some
studies further show that depression is a risk factorTrusted Source for SCD.
Previous research has
moreover suggested that some antidepressant medications are
associated with a higher risk of cardiovascular issues, including SCDTrusted Source, stroke,
and atrial fibrillation.
“Antidepressants are
commonly prescribed for psychiatric conditions such as depression or OCD,” Jasmin
Mujkanovic, MD, a doctoral researcher in the Department of
Cardiology at Rigshospitalet Hjertecentret in Denmark told Medical
News Today.
“These
medications can have potential adverse effects such as QT
prolongation [when the heart muscle takes longer to contract
and relax], which may increase the risk for adverse arrhythmic events, and in
rare cases, SCD. It is important to recognize that having depression is itself
an independent risk factor for SCD/cardiovascular disease.”– Jasmin Mujkanovic,
MD
Mujkanovic is the first
author of a new study recently presented at EHRA 2025,
the scientific congress of the European Society of Cardiology, which further
confirms that antidepressant use may increase a person’s risk for SCD, and
differs between age groups and years of medication use.
1-year
antidepressant use linked to 56% increased risk of SCD
For this study,
Mujkanovic and his team analyzed medical information and death certificates for
Denmark adult residents between the ages of 18 and 90 in 2010.
Researchers categorized
participants by whether or not they had experienced SCD, and by their
antidepressant medication use — between 1 and 5 years, or 6 years and longer.
At the study’s conclusion, researchers found that
participants who used antidepressants for a period of 1 to 5 years had a 56%
increased risk of SCD.
Participants who used
antidepressants for 6 or more years had a 2.2 times higher risk for SCD.
“The significance of
these findings suggest that longer exposure time increases the risk for SCD,”
Mujkanovic said. “However, it is important to be cautious when interpreting
this. Longer duration might reflect more severe or persistent depression, which
itself contributes to cardiovascular risk. It is difficult to disentangle the
effects of medication from the underlying condition.”
High
SCD incidence rate for those taking antidepressants for 6+ years
When breaking down study
results by age groups, researchers found some differences in antidepressant use
and SCD risk.
For participants between the ages of 30–39, those
who used antidepressants for 1 to 5 years were three times more likely to
experience SCD than those who did not take the medications. This risk increased
to five times higher if they used antidepressants for 6 or more years.
In the 50-59 age group,
1 to five years use of antidepressant medications doubled their SCD risk, and
quadrupled for those using the drugs for 6 or more years.
And when looking at
participants between the ages of 40 to 79, scientists found their SCD incidence
rate ratio was significantly higher for those who used antidepressants for 6
years or more compared to those who used them for 1 to 5 years.
“Within each age group,
those exposed to antidepressants had a higher risk of SCD, compared to their
unexposed peers,” Mujkanovic explained.
“However, overall, a
30-39 year old on antidepressants would still have a lower absolute risk than
an unexposed 70-79 year old,“ he noted. “This is largely due to competing risk,
as baseline risk for SCD increases with age. While antidepressant exposure may
increase relative risk in younger individuals, their absolute risk remains
lower than that of older individuals.”
However, Mujkanovic also
provided some reassurance:
“The
main takeaway [from this study] is please do not panic if you are on antidepressants.
Although the study shows that the risk is increased among the exposed,
depression is itself an independent risk factor for cardiovascular disease and
SCD. The increased risk is most likely multifactorial, and this highlights the
need for a more holistic approach to managing mental health as well as
cardiovascular health in these patients.”
Why
might antidepressant use contribute to heart problems?
MNT had the opportunity to speak with Cheng-Han
Chen, MD, a board-certified interventional cardiologist and medical
director of the Structural Heart Program at MemorialCare Saddleback Medical
Center in Laguna Hills, CA, about this study.
“This study found an
association between antidepressant use and future risk of SCD,” Chen, who was
not involved in the research, commented. “As this was a population study, the
direction of causality cannot be determined.“
“It may be that the antidepressants increased
arrhythmias in patients, leading to an increased risk of SCD,” he hypothesized.
“However, it is also possible that the underlying depression itself led to
increased SCD, through increasing cardiovascular risk factors. Patients taking
antidepressant medications should talk to their physicians before making any
changes to their medications.”
“There is a close
relationship between depression and other areas of a person’s health, such as
their heart health,” he continued.
“Untreated depression
can increase someone’s risk of developing heart disease, and many people with
heart disease experience depression,” Chen further explained. ”Antidepressant
medications can thus play an important role in improving many aspects of an
individual’s health. Future research is needed to determine the mechanisms by
which antidepressants might increase someone’s risk of SCD.”
Should you worry about antidepressant use?
MNT also spoke with Grant R. Simons, MD, chief of Heart Rhythm Services at
Hackensack University Medical Center in New Jersey, not involved in the study,
about this research.
Simons commented that
while the findings might seem alarming at first glance, it is crucial to
consider the limitations of observational studies and avoid jumping to
conclusions about causality.
“Further research is needed to understand the
complex relationship between psychiatric disorders, antidepressant use, and SCD
risk,” he continued. “Patients should discuss any concerns about their
medication with their doctor and not discontinue treatment abruptly. While a 56%
increased risk and a doubled risk with longer-term use sounds dramatic, it’s
important to interpret these findings cautiously and within a broader context.”
For example, Simons said
the study shows an association, not necessarily a causal link, and this research
needs to be examined for whether it differentiates between classes of
antidepressants.
“It’s possible that
other factors related to having a psychiatric disorder and taking
antidepressants, such as lifestyle, other medications, or the underlying illness
itself, contribute to the increased risk of SCD,” he continued. “For example,
it is important to recognize that the use of antidepressants for longer periods
of time may be a marker for other risk factors for sudden death. The study may
have controlled for some of these, but it’s difficult to account for
everything.”
“It’s important to see
how this study aligns with previous research on this topic,” Simons added. “If
other studies have shown similar findings, it strengthens the evidence. If this
study contradicts previous research, more investigation is needed.”
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