Do antidepressants raise the risk of sudden cardiac death ?

Do antidepressants raise the risk of sudden cardiac death ?

Recent research suggests a potential link between long-term antidepressant use and an increased risk of sudden cardiac death (SCD), though the relationship is complex and influenced by factors such as duration of use, age, and underlying health conditions. Here’s a breakdown of the key findings:

1. Increased Risk with Longer Duration of Use

  • A 2025 Danish study analyzing 4.3 million adults found that those taking antidepressants for 1–5 years had a 56% higher risk of SCD, while those using them for 6+ years faced more than double the risk compared to the general population 259.
  • The risk was most pronounced in middle-aged adults (30–59 years), with those aged 30–39 showing 3x higher risk at 1–5 years and 5x higher risk at 6+ years of use 27.

2. Possible Mechanisms

  • Some antidepressants (e.g., tricyclics, SSRIs like citalopram) may prolong the QT interval, increasing the risk of dangerous arrhythmias like torsades de pointes 10.
  • Depression itself is a known risk factor for cardiovascular disease, making it difficult to isolate medication effects from the disease’s impact 58.
  • Long-term antidepressant use may also correlate with poorer lifestyle factors (e.g., smoking, inactivity) that contribute to heart disease 78.

3. Age and Risk Variability

  • The heightened risk was not statistically significant in adults under 30, possibly due to shorter exposure times 37.
  • Older adults (70+ years) still faced elevated risk, but the increase was less dramatic than in middle-aged groups 29.

4. Expert Caution Against Overinterpretation

  • Researchers emphasize that depression untreated carries its own cardiovascular risks, and abruptly stopping medication could be harmful 58.
  • Dr. Jasmin Mujkanovic, lead author of the Danish study, noted: “Longer exposure might reflect more severe depression, which itself contributes to cardiovascular risk” 57.

5. Recommendations for Patients

  • Do not stop antidepressants without consulting a doctor—untreated depression poses greater risks 58.
  • Regular cardiac monitoring (e.g., ECGs) may be advised for high-risk patients, especially those on long-term treatment 10.
  • Lifestyle interventions (exercise, smoking cessation) can mitigate cardiovascular risks 8.

Conclusion

While long-term antidepressant use is associated with increased SCD risk, the relationship is likely influenced by underlying depression severity and other health factors. Patients should not discontinue medication without medical guidance but may benefit from heart-health monitoring if on prolonged treatment. Further research is needed to clarify causation

Reference:

https://www.tctmd.com/news/sudden-cardiac-death-risk-linked-long-term-antidepressant-use

https://www.medicalnewstoday.com/articles/can-antidepressants-increase-sudden-cardiac-death-risk

https://www.medscape.com/viewarticle/antidepressants-linked-sudden-cardiac-death-risk-early-2025a10007wn?form=fpf

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