Association of Antidepressant Medications With Carotid Intima Media Thickness in Middle Aged Veteran Twins

Shah, Amit; Veledar, Emir; Shallenberger, Lucy; Murrah, Nancy; Jawed, Farhan; Bremner, Douglas; Goldberg, Jack; Vaccarino, Viola

doi:10.1016/s0735-1097(11)61588-x

Cited by 9 publications

(8 citation statements)

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“…Moreover, many plausible causal mechanisms have been identified including biological, 23,24 behavioral, 25 effects of psychotropic medications, 26 and inequities in health care provision. 27 However, some potential common underlying determinants of comorbid mental and physical ill health in adulthood have not yet been fully explored, such as genetics, diet, low birth weight, and predicators of early adverse circumstances.…”

Section: Discussionmentioning

confidence: 99%

Association of Mental Disorders With Subsequent Chronic Physical Conditions

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Association of Mental Disorders With Subsequent Chronic Physical Conditions

et al. 2016

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“…1-3 Clinicians and patients should be aware of a small but potentially clinically relevant increase in the risk of cardiovascular events and all-cause mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Antidepressant use has been linked to thicker arteries, which could contribute to the risk of heart disease and stroke. 1 One study reported that the carotid intima-media thickness was five percent greater for twins taking vs not taking antidepressants. 1 This was true both for selective serotonin reuptake inhibitors (SSRIs) and other antidepressants (which included serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAO-Is), and other miscellaneous antidepressants).…”

Section: Introductionmentioning

confidence: 99%

“…1 One study reported that the carotid intima-media thickness was five percent greater for twins taking vs not taking antidepressants. 1 This was true both for selective serotonin reuptake inhibitors (SSRIs) and other antidepressants (which included serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAO-Is), and other miscellaneous antidepressants). For cerebrovascular disease, one prior study found that patients with major depression taking SSRIs as monotherapy over a 19 year period had a higher risk of stroke (adjusted risk ratio = 1.18) if they had taken a drug with high as opposed to low affinity for the serotonin transporter.…”

Section: Introductionmentioning

confidence: 99%

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Antidepressant Medication Use and Its Association With Cardiovascular Disease and All-Cause Mortality in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

et al. 2016

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Background Mixed evidence suggests second-generation antidepressants may increase risk of cardiovascular and cerebrovascular events. Objective Assess whether antidepressant use is associated with acute coronary heart disease, stroke, cardiovascular disease death, and all-cause mortality. Methods Secondary analyses of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) longitudinal cohort study were conducted. Use of selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, bupropion, nefazodone, and trazodone was measured during the baseline (2003-2007) in-home visit. Outcomes of coronary heart disease, stroke, cardiovascular disease death, and all-cause mortality were assessed every 6 months and adjudicated by medical record review. Cox proportional hazards time-to-event analysis followed patients until their first event on or before December 31, 2011, iteratively adjusting for covariates. Results Among 29,616 participants, 3,458 (11.7%) used an antidepressant of interest. Intermediate models adjusting for everything but physical and mental health found an increased risk of acute coronary heart disease (Hazard Ratio=1.21; 95% CI 1.04-1.41), stroke (Hazard Ratio=1.28; 95% CI 1.02-1.60), cardiovascular disease death (Hazard Ratio =1.29; 95% CI 1.09-1.53), and all-cause mortality (Hazard Ratio=1.27; 95% CI 1.15-1.41) for antidepressant users. Risk estimates trended in this direction for all outcomes in the fully adjusted model, but only remained statistically associated with increased risk of all-cause mortality (Hazard Ratio=1.12; 95% CI 1.01-1.24). This risk was attenuated in sensitivity analyses censoring follow-up time at 2-years (Hazard Ratio=1.37; 95% CI 1.11-1.68). Conclusions In fully adjusted models antidepressant use was associated with a small increase in all-cause mortality.

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“…A recent meta-analysis of these studies suggests that the use of SSRIs is associated with an odds ratio of 1.48 (CI = 1.08, 2.02) for ischemic stroke (Shin et al, 2014). Likewise, an association between increased carotid intimal-medial thickening, a powerful predictor of myocardial infarct risk (Simon et al, 2002), and SSRI treatment in a study of twins discordant for SSRI has been reported (reported in Shah et al, 2011 American College of Cardiology Scientific Sessions).…”

Section: Introductionmentioning

confidence: 92%

The impact of treatment with selective serotonin reuptake inhibitors on primate cardiovascular disease, behavior, and neuroanatomy

Shively

Silverstein‐Metzler

Justice

et al. 2017

Neuroscience & Biobehavioral Reviews

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Selective serotonin reuptake inhibitor (SSRI) use is ubiquitous because they are widely prescribed for a number of disorders in addition to depression. Depression increases the risk of coronary heart disease (CHD). Hence, treating depression with SSRIs could reduce CHD risk. However, the effects of long term antidepressant treatment on CHD risk, as well as other aspects of health, remain poorly understood. Thus, we undertook an investigation of multisystem effects of SSRI treatment with a physiologically relevant dose in middle-aged adult female cynomolgus monkeys, a primate species shown to be a useful model of both depression and coronary and carotid artery atherosclerosis. Sertraline had no effect on depressive behavior, reduced anxious behavior, increased affiliation, reduced aggression, changed serotonin neurotransmission and volumes of neural areas critical to mood disorders, and exacerbated coronary and carotid atherosclerosis. These data suggest that a conservative approach to prescribing SSRIs for cardiovascular or other disorders for long periods may be warranted, and that further study is critical given the widespread use of these medications.

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Association of Antidepressant Medications With Carotid Intima Media Thickness in Middle Aged Veteran Twins

Cited by 9 publications

References 0 publications

Association of Mental Disorders With Subsequent Chronic Physical Conditions

Association of Mental Disorders With Subsequent Chronic Physical Conditions

Antidepressant Medication Use and Its Association With Cardiovascular Disease and All-Cause Mortality in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

The impact of treatment with selective serotonin reuptake inhibitors on primate cardiovascular disease, behavior, and neuroanatomy

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