Antidepressants not the culprit in depression linked to heart attacks

The increased risk of heart attack associated with taking antidepressants may be caused by the depression itself rather than the drugs themselves, suggests new research reported in the current issue in the British Medical Journal. At least one in 10 older people are prescribed antidepressants.

The findings, based on anonymous prescribing supplied from 644 general practices across the UK, on 60,000 patients who had had their first heart attack between 1998 and 2001 and 360,000 randomly selected others, matched for age and sex, were analyzed and showed there was an increased risk of a first heart attack within the first month of taking antidepressants.

Patients prescribed the older class of tricyclic antidepressants (TCAs) for the first time were twice as likely to have a heart attack within the next seven days as patients who had not been prescribed these drugs and patients prescribed the newer selective serotonin reuptake inhibitors (SSRIs) were twice as likely to have a heart attack within the next seven days. Patients who took antidepressants for longer than a month had a much lower risk of a heart attack. After taking account of the extent of existing cardiovascular disease and depression these risks disappeared. This was found from looking at the prescription data before and after the heart attack. The conclusion arrived at was that any increased heart attack risk is more likely to be linked to the underlying depression rather than the drugs themselves.

The authors also failed to find any link with specific antidepressants or with the class of drug.