LOGIN TO YOUR ACCOUNT

Username
Password
Remember Me
Or use your Academic/Social account:

CREATE AN ACCOUNT

Or use your Academic/Social account:

Congratulations!

You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.

Important!

Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message

CREATE AN ACCOUNT

Name:
Username:
Password:
Verify Password:
E-mail:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Publisher: BMJ Publishing Group
Journal: The BMJ
Types: Article
Subjects: Research

Classified by OpenAIRE into

mesheuropmc: cardiovascular diseases
Objective\ud To assess associations between different antidepressant treatments and rates of three cardiovascular outcomes (myocardial infarction, stroke or transient ischaemic attack, and arrhythmia) in people with depression.\ud Design\ud Cohort study.\ud Setting\ud UK general practices contributing to the QResearch primary care database.\ud Participants\ud 238 963 patients aged 20 to 64 years with a first diagnosis of depression between 1 January 2000 and 31 July 2011.\ud Exposures\ud Antidepressant class (tricyclic and related antidepressants, selective serotonin reuptake inhibitors, other antidepressants), dose, duration of use, and commonly prescribed individual antidepressant drugs.\ud Main outcome measures\ud First diagnoses of myocardial infarction, stroke or transient ischaemic attack, and arrhythmia during five years’ follow-up. Cox proportional hazards models were used to estimate hazard ratios, adjusting for potential confounding variables.\ud Results\ud During five years of follow-up, 772 patients had a myocardial infarction, 1106 had a stroke or transient ischaemic attack, and 1452 were diagnosed as having arrhythmia. No significant associations were found between antidepressant class and myocardial infarction over five years’ follow-up. In the first year of follow-up, patients treated with selective serotonin reuptake inhibitors had a significantly reduced risk of myocardial infarction (adjusted hazard ratio 0.58, 95% confidence interval 0.42 to 0.79) compared with no use of antidepressants; among individual drugs, fluoxetine was associated with a significantly reduced risk (0.44, 0.27 to 0.72) and lofepramine with a significantly increased risk (3.07, 1.50 to 6.26). No significant associations were found between antidepressant class or individual drugs and risk of stroke or transient ischaemic attack. Antidepressant class was not significantly associated with arrhythmia over five years’ follow-up, although the risk was significantly increased during the first 28 days of treatment with tricyclic and related antidepressants (adjusted hazard ratio 1.99, 1.27 to 3.13). Fluoxetine was associated with a significantly reduced risk of arrhythmia (0.74, 0.59 to 0.92) over five years, but citalopram was not significantly associated with risk of arrhythmia even at high doses (1.11, 0.72 to 1.71 for doses ≥40 mg/day).\ud Conclusions\ud This study found no evidence that selective serotonin reuptake inhibitors are associated with an increased risk of arrhythmia or stroke/transient ischaemic attack in people diagnosed as having depression between the ages of 20 to 64 or that citalopram is associated with a significantly increased risk of arrhythmia. It found some indication of a reduced risk of myocardial infarction with selective serotonin reuptake inhibitors, particularly fluoxetine, and of an increased risk with lofepramine.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1 Hatcher S, Arroll B. Newer antidepressants for the treatment of depression in adults. BMJ 2012;344:d8300. doi:10.1136/bmj. d8300.
    • 2 Jolly K, Langman MJS. Psychotropic medication: curing illness or creating problems?Heart 2009;95:1893-4. doi:10.1136/ hrt.2009.179127.
    • 3 Olfson M, Marcus SC. National patterns in antidepressant medication treatment. Arch Gen Psychiatry 2009;66:848-56. doi:10.1001/ archgenpsychiatry.2009.81.
    • 4 Lockhart P, Guthrie B. Trends in primary care antidepressant prescribing 1995-2007: a longitudinal population database analysis. Br J Gen Pract 2011;61:e565-72. doi:10.3399/bjgp11X593848.
    • 5 Stephenson CP, Karanges E, McGregor IS. Trends in the utilisation of psychotropic medications in Australia from 2000 to 2011. Aust N Z J Psychiatry 2013;47:74-87. doi:10.1177/0004867412466595.
    • 6 Pratt L, Brody D, Gu Q. Antidepressant use in persons aged 12 and over: United States, 2005-2008. NCHS data brief, no 76. National Center for Health Statistics, 2011.
    • 7 Health and Social Care Information Centre. Prescription cost analysis, England 2013. 2014. http://www.hscic.gov.uk/catalogue/PUB13887.
    • 8 Department of Health. Prescription cost analysis: England 2003. 2004. http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/ en/Publicationsandstatistics/Statistics/StatisticalWorkAreas/ Statisticalhealthcare/DH_4086603.
    • 9 Shin D, Oh YH, Eom CS, Park SM. Use of selective serotonin reuptake inhibitors and risk of stroke: a systematic review and meta-analysis. J Neurol 2014;261:686-95. doi:10.1007/s00415-014-7251-9.
    • 10 Coupland C, Dhiman P, Morriss R, Arthur A, Barton G, Hippisley-Cox J. Antidepressant use and risk of adverse outcomes in older people: population based cohort study. BMJ 2011;343:d4551. doi:10.1136/ bmj.d4551.
    • 11 Meier CR, Schlienger RG, Jick H. Use of selective serotonin reuptake inhibitors and risk of developing first-time acute myocardial infarction. Br J Clin Pharmacol 2001;52:179-84. doi:10.1046/j.0306-5251.2001.01426.x.
    • 12 Monster TB, Johnsen SP, Olsen ML, McLaughlin JK, Sørensen HT. Antidepressants and risk of first-time hospitalization for myocardial infarction: a population-based case-control study. Am J Med 2004;117:732-7. doi:10.1016/j.amjmed.2004.06.027.
    • 13 Schlienger RG, Fischer LM, Jick H, Meier CR. Current use of selective serotonin reuptake inhibitors and risk of acute myocardial infarction. Drug Saf 2004;27:1157-65. doi:10.2165/00002018-200427140-00006.
    • 14 US Food and Drug Administration. FDA Drug Safety Communication. FDA Drug Safety Communication: Abnormal heart rhythms associated with high doses of Celexa (citalopram hydrobromide). 2011. www.fda. gov/Drugs/DrugSafety/ucm269086.htm.
    • 15 Castro VM, Clements CC, Murphy SN, et al. QT interval and antidepressant use: a cross sectional study of electronic health records. BMJ 2013;346:f288. doi:10.1136/bmj.f288.
    • 16 Girardin FR, Gex-Fabry M, Berney P, Shah D, Gaspoz JM, Dayer P. Drug-induced long QT in adult psychiatric inpatients: the 5-year cross-sectional ECG Screening Outcome in Psychiatry study. Am J Psychiatry 2013;170:1468-76. doi:10.1176/appi.ajp.2013.12060860.
    • 17 El-Sherif N, Turitto G. Torsade de pointes. Curr Opin Cardiol 2003;18:6-13. doi:10.1097/00001573-200301000-00002.
    • 18 Zivin K, Pfeifer PN, Bohnert ASB, et al. Evaluation of the FDA warning against prescribing citalopram at doses exceeding 40 mg. Am J Psychiatry 2013;170:642-50. doi:10.1176/appi.ajp.2013.12030408.
    • 19 Leonard CE, Bilker WB, Newcomb C, Kimmel SE, Hennessy S. Antidepressants and the risk of sudden cardiac death and ventricular arrhythmia. Pharmacoepidemiol Drug Saf 2011;20:903-13.21796718.
    • 20 Coupland C, Morriss R, Arthur A, Moore M, Hill T, Hippisley-Cox J. Safety of antidepressants in adults aged under 65: protocol for a cohort study using a large primary care database. BMC Psychiatry 2013;13:135. doi:10.1186/1471-244X-13-135.
    • 21 Hill T, Coupland C, Morriss R, Arthur A, Moore M, Hippisley-Cox J. Antidepressant use and risk of epilepsy and seizures in people aged 20 to 64 years: cohort study using a primary care database. BMC Psychiatry 2015;15:315. doi:10.1186/s12888-015-0701-9.
    • 22 Coupland C, Hill T, Morriss R, Arthur A, Moore M, Hippisley-Cox J. Antidepressant use and risk of suicide and attempted suicide or self harm in people aged 20 to 64: cohort study using a primary care database. BMJ 2015;350:h517. doi:10.1136/bmj.h517.
    • 23 Martinez C, Rietbrock S, Wise L, et al. Antidepressant treatment and the risk of fatal and non-fatal self harm in first episode depression: nested case-control study. BMJ 2005;330:389. doi:10.1136/ bmj.330.7488.389.
    • 24 Hippisley-Cox J, Pringle M, Hammersley V, et al. Antidepressants as risk factor for ischaemic heart disease: case-control study in primary care. BMJ 2001;323:666-9. doi:10.1136/bmj.323.7314.666.
    • 25 Coupland CA, Dhiman P, Barton G, et al. A study of the safety and harms of antidepressant drugs for older people: a cohort study using a large primary care database. Health Technol Assess 2011;15:1-202, iii-iv. doi:10.3310/hta15280.
    • 26 Hippisley-Cox J, Coupland C. Risk of myocardial infarction in patients taking cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs: population based nested case control analysis. BMJ 2005;330:1366-74. doi:10.1136/bmj.330.7504.1366.
    • 27 Hippisley-Cox J, Coupland C, Brindle P. Derivation and validation of QStroke score for predicting risk of ischaemic stroke in primary care and comparison with other risk scores: a prospective open cohort study. BMJ 2013;346:f2573. doi:10.1136/bmj.f2573.
    • 28 FDA Drug Safety Communication. FDA Drug Safety Communication: Revised recommendations for Celexa (citalopram hydrobromide) related to a potential risk of abnormal heart rhythms with high doses. 2012. http://www.fda.gov/Drugs/DrugSafety/ucm297391.htm.
    • 29 Altman DG, Andersen PK. Calculating the number needed to treat for trials where the outcome is time to an event. BMJ 1999;319:1492-5. doi:10.1136/bmj.319.7223.1492.
    • 30 Nicholson A, Kuper H, Hemingway H. Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146 538 participants in 54 observational studies. Eur Heart J 2006;27:2763-74. doi:10.1093/eurheartj/ehl338.
    • 31 Pan A, Sun Q, Okereke OI, Rexrode KM, Hu FB. Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review. JAMA 2011;306:1241-9. doi:10.1001/jama.2011.1282.
    • 32 Taylor D. Antidepressant drugs and cardiovascular pathology: a clinical overview of efectiveness and safety. Acta Psychiatr Scand 2008;118:434-42. doi:10.1111/j.1600-0447.2008.01260.x.
    • 33 National Institute for Health and Care Excellence. Depression: the treatment and management of depression in adults.NICE, 2009.
    • 34 Herrett E, Thomas SL, Schoonen WM, Smeeth L, Hall AJ. Validation and validity of diagnoses in the General Practice Research Database: a systematic review. Br J Clin Pharmacol 2010;69:4-14. doi:10.1111/j.1365-2125.2009.03537.x.
    • 35 Khan NF, Harrison SE, Rose PW. Validity of diagnostic coding within the General Practice Research Database: a systematic review. Br J Gen Pract 2010;60:e128-36. doi:10.3399/bjgp10X483562.
    • 36 Hennessy S, Leonard CE, Palumbo CM, Bilker WB, Newcomb C, Kimmel SE. Diagnostic codes for sudden cardiac death and ventricular arrhythmia functioned poorly to identify outpatient events in EPIC's General Practice Research Database. Pharmacoepidemiol Drug Saf 2008;17:1131-6. doi:10.1002/pds.1632.
    • 37 Thanacoody HKR, Thomas SH. Tricyclic antidepressant poisoning : cardiovascular toxicity. Toxicol Rev 2005;24:205-14. doi:10.2165/00139709-200524030-00013.
    • 38 Roose SP, Glassman AH, Giardina EG, Walsh BT, Woodring S, Bigger JT. Tricyclic antidepressants in depressed patients with cardiac conduction disease. Arch Gen Psychiatry 1987;44:273-5. doi:10.1001/archpsyc.1987.01800150093011.
    • 39 Blanchette CM, Simoni-Wastila L, Stuart B. Cardiovascular risk of antidepressant use in elderly medicare beneficiaries: comparison by therapeutic class. Ann Epidemiol 2005;15:643-4doi:10.1016/j. annepidem.2005.06.039.
    • 40 Tata LJ, West J, Smith C, et al. General population based study of the impact of tricyclic and selective serotonin reuptake inhibitor antidepressants on the risk of acute myocardial infarction. Heart 2005;91:465-71. doi:10.1136/hrt.2004.037457.
    • 41 Cohen HW, Gibson G, Alderman MH. Excess risk of myocardial infarction in patients treated with antidepressant medications: association with use of tricyclic agents. Am J Med 2000;108:2-8. doi:10.1016/S0002-9343(99)00301-0.
    • 42 Smoller JW, Allison M, Cochrane BB, et al. Antidepressant use and risk of incident cardiovascular morbidity and mortality among postmenopausal women in the Women's Health Initiative study. Arch Intern Med 2009;169:2128-39. doi:10.1001/archinternmed.2009.436.
    • 43 Kimmel SE, Schelleman H, Berlin JA, et al. The efect of selective serotonin re-uptake inhibitors on the risk of myocardial infarction in a cohort of patients with depression. Br J Clin Pharmacol 2011;72:514-7. doi:10.1111/j.1365-2125.2011.04008.x.
    • 44 Sauer WH, Berlin JA, Kimmel SE. Selective serotonin reuptake inhibitors and myocardial infarction. Circulation 2001;104:1894-8. doi:10.1161/hc4101.097519.
    • 45 Oh SW, Kim J, Myung SK, Hwang SS, Yoon DH. Antidepressant use and risk of coronary heart disease: meta-analysis of observational studies. Br J Clin Pharmacol 2014;78:727-37. doi:10.1111/bcp.12383.
    • 46 Turnheim K. When drug therapy gets old: pharmacokinetics and pharmacodynamics in the elderly. Exp Gerontol 2003;38:843-53. doi:10.1016/S0531-5565(03)00133-5.
    • 47 Castro VM, Gallagher PJ, Clements CC, et al. Incident user cohort study of risk for gastrointestinal bleed and stroke in individuals with major depressive disorder treated with antidepressants. BMJ Open 2012;2:e000544. doi:10.1136/bmjopen-2011-000544.
    • 48 Chen Y, Guo JJ, Li H, Wulsin L, Patel NC. Risk of cerebrovascular events associated with antidepressant use in patients with depression: a population-based, nested case-control study. Ann Pharmacother 2008;42:177-84. doi:10.1345/aph.1K369.
    • 49 Trifirò G, Dieleman J, Sen EF, Gambassi G, Sturkenboom MC. Risk of ischemic stroke associated with antidepressant drug use in elderly persons. J Clin Psychopharmacol 2010;30:252-8. doi:10.1097/ JCP.0b013e3181dca10a.
    • 50 Pan A, Okereke OI, Sun Q, et al. Depression and incident stroke in women. Stroke 2011;42:2770-5. doi:10.1161/STROKEAHA.111.617043.
    • 51 Hung CC, Lin CH, Lan TH, Chan CH. The association of selective serotonin reuptake inhibitors use and stroke in geriatric population. Am J Geriatr Psychiatry 2013;21:811-5. doi:10.1016/j. jagp.2013.01.018.
    • © BMJ Publishing Group Ltd 2016
  • Inferred research data

    The results below are discovered through our pilot algorithms. Let us know how we are doing!

    Title Trust
    73
    73%
  • No similar publications.