Antidepressants and the risk of sudden cardiac death and ventricular arrhythmia

Posted by: admin on: February 20, 2012

A study was conducted to compare the risks of cardiac death and ventricular arrhythmia in patients on various antidepressants. Other than Mirtazapine which had a high risk, all other eleven drugs used in the study had the same risk level. Read on to know more.


PURPOSE: To examine the association between exposure to antidepressants and emergency department or inpatient admission for sudden cardiac death and ventricular arrhythmia (SD/VA), and to examine the impact of dose and cytochrome P-450 inhibition.

METHODS: A cohort study was conducted using 1999-2003 Medicaid claims data from beneficiaries of five large states, supplemented with Medicare claims for dually eligible individuals. Exposures were prescription claims for antidepressants of interest or a reference antidepressant. Outcomes were incident first-listed emergency department or principal inpatient diagnoses indicative of SD/VA originating in the outpatient setting, an outcome previously found to have a positive predictive value of 85%.

CONCLUSIONS: Of antidepressants studied, only mirtazapine had a statistically significantly greater SD/VA risk versus paroxetine. However, baseline differences between these users suggest that this finding may be attributable to residual confounding. Eleven other antidepressants had SD/VA risks no greater than that of paroxetine, thereby providing reassurance regarding the comparative cardiovascular safety of antidepressants.


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