1. Antidepressant use and risk of out-of-hospital cardiac arrest: a nationwide case-time-control study.
- Author
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Weeke P, Jensen A, Folke F, Gislason GH, Olesen JB, Andersson C, Fosbøl EL, Larsen JK, Lippert FK, Nielsen SL, Gerds T, Andersen PK, Kanters JK, Poulsen HE, Pehrson S, Køber L, and Torp-Pedersen C
- Subjects
- Aged, Case-Control Studies, Citalopram administration & dosage, Death, Sudden, Cardiac epidemiology, Death, Sudden, Cardiac prevention & control, Denmark, Depression drug therapy, Female, Humans, Logistic Models, Male, Middle Aged, Nortriptyline administration & dosage, Odds Ratio, Out-of-Hospital Cardiac Arrest epidemiology, Risk Assessment, Time Factors, Antidepressive Agents adverse effects, Antidepressive Agents classification, Citalopram adverse effects, Death, Sudden, Cardiac etiology, Nortriptyline adverse effects, Out-of-Hospital Cardiac Arrest chemically induced
- Abstract
Treatment with some types of antidepressants has been associated with sudden cardiac death. It is unknown whether the increased risk is due to a class effect or related to specific antidepressants within drug classes. All patients in Denmark with an out-of-hospital cardiac arrest (OHCA) were identified (2001-2007). Association between treatment with specific antidepressants and OHCA was examined by conditional logistic regression in case-time-control models. We identified 19,110 patients with an OHCA; 2,913 (15.2%) were receiving antidepressant treatment at the time of OHCA, with citalopram being the most frequently used type of antidepressant (50.8%). Tricyclic antidepressants (TCAs; odds ratio (OR) = 1.69, confidence interval (CI): 1.14-2.50) and selective serotonin reuptake inhibitors (SSRIs; OR = 1.21, CI: 1.00-1.47) were both associated with comparable increases in risk of OHCA, whereas no association was found for serotonin-norepinephrine reuptake inhibitors/noradrenergic and specific serotonergic antidepressants (SNRIs/NaSSAs; OR = 1.06, CI: 0.81-1.39). The increased risks were primarily driven by: citalopram (OR = 1.29, CI: 1.02-1.63) and nortriptyline (OR = 5.14, CI: 2.17-12.2). An association between cardiac arrest and antidepressant use could be documented in both the SSRI and TCA classes of drugs.
- Published
- 2012
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