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- Title
In adults >65 years of age, antidepressant drugs were not linked to increased risk for CV outcomes.
- Authors
Pal, Hem Raj
- Abstract
Question In adults >65 years of age with depression, what is the relation between antidepressant drug treatment and cardiovascular (CV) outcomes? Methods Design Cohort study using data from a UK primary care research database (QResearch), with 5-year follow-up. Setting 687 general practices in the UK. Patients 238963 patients 20 to 64 years of age (mean age 40 y, 61% women) with a first depression diagnosis between 2000 and Jul 2011. Exclusion criteria were registration in a study practice or practice initial participation in the research database >12 months before depression diagnosis; previous depression diagnosis; schizophrenia, bipolar disorder, or other psychosis; previous prescriptions for lithium or antimanic drugs; temporary residency; or antidepressant drug prescription before any of the following: Jan 2000, registration with the study practice, 20 years of age, or <3 years before the first recorded depression diagnosis. Nonexposure periods (the reference category) included those during which a patient was not treated with the relevant antidepressant drug and included patients who were not exposed during the study. Risk factors Exposure to antidepressant drugs (tricyclic and related antidepressants [TCAs], selective serotonin-reuptake inhibitors [SSRIs], or other antidepressant drugs [e.g., venlafaxine, mirtazapine]). Exposure periods continued to 90 days after drug use was stopped. Individual patients could contribute to ≥1 exposure period for ≥1 drug and ≥1 nonexposure period. Outcomes Outcomes were first arrhythmia, myocardial infarction (MI), and stroke or transient ischemic attack. Hazard ratios compared rates of the outcomes between exposed and unexposed periods. Main results 88% of patients had ≥1 prescription for antidepressant drugs; 71% of prescriptions were for SSRIs, 16% for TCAs, and 13% for other antidepressants. Associations between antidepressant classes and CV outcomes are shown in the Table. Conclusion In adults >65 years of age with depression, antidepressant drug use was not linked to increased risk for arrhythmia, myocardial infarction, or stroke or transient ischemic attack.
- Subjects
UNITED Kingdom; MENTAL depression; ANTIDEPRESSANTS; ARRHYTHMIA; CARDIOVASCULAR diseases; CONFIDENCE intervals; DATABASES; FAMILY medicine; MEDICAL information storage &; retrieval systems; LONGITUDINAL method; EVALUATION of medical care; MYOCARDIAL infarction; PRIMARY health care; STROKE; DESCRIPTIVE statistics
- Publication
ACP Journal Club, 2016, Vol 165, Issue 2, p9
- ISSN
1056-8751
- Publication type
Article
- DOI
10.7326/ACPJC-2016-165-2-010