Current Use of Selective Serotonin Reuptake Inhibitors and Risk of Acute Myocardial Infarction

Schlienger, Raymond G.; Fischer, Lorenz; Jick, Hershel; Meier, Christoph

doi:10.2165/00002018-200427140-00006

Cited by 76 publications

(66 citation statements)

References 48 publications

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“…16 Evidence of a protective effect is largely limited to SSRIs. 139,140 Our study found no clear evidence of a difference in myocardial risk between antidepressant classes, although there was some indication of an increased risk associated with SSRIs, mostly confined to fluoxetine and occurring during the first 28 days of use.…”

Section: Myocardial Infarctioncontrasting

confidence: 54%

“…139 A slight protective effect of current use of SSRIs on acute MI was also found in a study using GPRD data, 140 but not for other antidepressant drugs. However, recent past SSRI use was associated with a slightly raised risk.…”

Section: Myocardial Infarctionmentioning

confidence: 78%

“…16 Overall, there are no clear findings in the literature for MI risk and antidepressant use in older people. While some studies have provided evidence of increased risk of MI with antidepressant use, 17,18,78,141 others have found that antidepressant drugs confer a protective effect, 77,139,140 with others finding no association. 32 Increased risk has been observed as being restricted to TCAs, 78 SSRIs 141 or across classes 17,18 or restricted to particular drugs.…”

Section: Myocardial Infarctionmentioning

confidence: 99%

See 2 more Smart Citations

A study of the safety and harms of antidepressant drugs for older people: a cohort study using a large primary care database

Coupland

Dhiman²,

Barton³

et al. 2011

Health Technol Assess

107

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An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTAA study of the safety and harms of antidepressant drugs for older people: a cohort study using a large primary care database NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA programme is needs led in that it fills gaps in the evidence nee...

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Section: Myocardial Infarctioncontrasting

confidence: 54%

Section: Myocardial Infarctionmentioning

confidence: 78%

Section: Myocardial Infarctionmentioning

confidence: 99%

See 1 more Smart Citation

A study of the safety and harms of antidepressant drugs for older people: a cohort study using a large primary care database

Coupland

Dhiman²,

Barton³

et al. 2011

Health Technol Assess

107

View full text Add to dashboard Cite

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“…However, a recent population-based case control analysis by Schlienger et al indicated that current use of selective serotonin reuptake inhibitors (SSRIs) may be associated with a slight reduction in risk of an acute cardiac event (14).…”

Section: Introductionmentioning

confidence: 99%

Specific Serotonin Reuptake Inhibition in Major Depressive Disorder Adversely Affects Novel Markers of Cardiac Risk

et al. 2007

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There exists a growing body of evidence linking depression with cardiovascular events, although the mechanisms responsible remain unknown. We investigated the role of the autonomic nervous system and inflammation in the link between coronary heart disease and major depressive disorder (MDD), and examined the cardiac risk modification following pharmacological treatment of depression. We measured cardiac baroreflex function, heart rate variability, pulse pressure and high sensitivity C-reactive protein (hsCRP), all of which have an impact on cardiac risk, pre-and post-treatment in 25 patients with MDD, with no history of coronary heart disease, and in 15 healthy subjects. Treatment consisted of selective serotonin reuptake inhibitors for approximately 12 weeks. No significant differences were observed between untreated MDD patients and healthy subjects in blood pressure, heart rate, baroreflex sensitivity or heart rate variability.Pulse pressure and hsCRP, however, were significantly elevated in patients with MDD prior to treatment (p =0.023 and p =0.025, respectively). Moreover, while pharmacotherapy was effective in alleviating depression, surprisingly, each of cardiac baroreflex function, heart rate variability, pulse pressure and hsCRP was modified (p <0.05) in a manner likely to increase cardiac risk. In conclusion, this study demonstrated higher pulse pressure and hsCRP plasma levels in patients with MDD, which might contribute to increased cardiac risk. Following treatment vagal activity was reduced, as indicated by reductions in baroreflex sensitivity and heart rate variability, accompanied by increases in pulse pressure and plasma hsCRP levels. Mechanisms potentially responsible for generating cardiac risk in patients treated with selective serotonin reuptake inhibitors may need to be therapeutically targeted to reduce the incidence of coronary heart disease in this pop-

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“…Several observational studies have also suggested that, in patients with acute coronary syndromes, treatment with an SSRI is associated with improved cardiovascular outcomes. 12,13 Based on converging lines of evidence, we can be confident that SSRIs alter platelet function and that some patients will bleed as a result. How should we use this information?…”

mentioning

confidence: 99%

Antidepressants, antiplatelets and bleeding: One more thing to worry about?

Juurlink¹

2011

Canadian Medical Association Journal

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Current Use of Selective Serotonin Reuptake Inhibitors and Risk of Acute Myocardial Infarction

Abstract: The present analysis provides further evidence that the current use of SSRIs is associated with a slightly decreased risk for AMI.

Cited by 76 publications

References 48 publications

A study of the safety and harms of antidepressant drugs for older people: a cohort study using a large primary care database

A study of the safety and harms of antidepressant drugs for older people: a cohort study using a large primary care database

Specific Serotonin Reuptake Inhibition in Major Depressive Disorder Adversely Affects Novel Markers of Cardiac Risk

Antidepressants, antiplatelets and bleeding: One more thing to worry about?

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