SSRI Antidepressants Not Tied to Cardiovascular Conditions

Commonly prescribed antidepressants, called selective serotonin reuptake inhibitors (SSRIs) are not associated with an increased risk of heart conditions, such as heart attacks and stroke, according to recent research published in the BMJ.

While depression is known to increase the risk of cardiovascular problems, it has not been clear whether that risk is tied to antidepressant use. Previously, it’s been thought that SSRIs may affect coagulation, leading to cardiovascular disease — but this association has not been confirmed.

The Food and Drug Administration and the European Medicines Association both issued warnings in 2011 about the risk of taking high doses of citalopram (Celexa), one of the most commonly prescribed antidepressants. A dose of citalopram should not exceed 40 mg per day, both agencies said.

Yet, according to the BMJ study, citalopram, the most commonly prescribed antidepressant among patients in the study, was not associated with an increased risk of arrhythmia, even at higher doses. Still, the authors note that higher doses may pose a risk, because only 18 percent of the citalopram prescriptions in the study were for higher doses.

Researchers at The University of Nottingham analyzed a cohort of nearly 239,000 patients, ages 20 to 64, who had been diagnosed with depression. The patients were monitored for heart attacks, stroke, or transient ischaemic attacks and arrhythmia. When the researchers looked at tricyclic antidepressants, SSRIs and other types of antidepressants — and adjusted for age, gender, alcohol and tobacco use, other conditions and use of other medications — they didn’t see an increase in cardiovascular conditions among patients on SSRIs.

In a 5-year period, 772 patients had a myocardial infraction; 1,106 had a stroke of transient ischemic attack; and 1,452 had arrhythmia. But there was no evidence that SSRIs increased the risk of these cardiovascular conditions.

But during the first four weeks of taking tricyclic and related antidepressants, there was double the risk of experiencing arrhythmia.

“In addition, we found some indication that SSRIs were associated with a reduced risk of heart attacks, particularly with the use of fluoxetine (Prozac),” said study author Carol Coupland, of Nottingham University.

It’s important to note that these results do not prove a causative link, because this is an observational study.

Antidepressant use in the U.S. has skyrocketed: Adults in the U.S. consumed four times more antidepressants in the late 2000s than they did in the early 1990s. Antidepressants are the third most frequently taken drug in the U.S. and researchers estimate that 8 to 10 percent of the population is taking an antidepressant, according to the Centers for Disease Control and Prevention.