New research has discovered that the older-style anti-depressants can cause a higher risk of heart disease.
People who took tricylic anti-depressants, had a greater risk of all cardiovascular events such as heart attack or stroke compared with people who did not take any anti-depressant medication. People taking other types of anti-depressant medication (e.g. SSRIs) did not have an increased risk of cardiovascular events.
The survey looked at people’s physical and mental health, lifestyle factors (such as smoking and alcohol intake) and their height, weight and blood pressure. The researchers combined data from a sample of people from these three surveys with data from hospital admissions and death certificates. The researchers say that people who take anti-depressants are also more likely to smoke, be overweight and do little physical activity.
The survey also assessed the participants’ mental health using the General Health Questionnaire (GHQ-12) for anxiety and depression symptoms and participants were asked about any anti-depressant medications they were currently taking. Hospital records were used to identify psychiatric admissions.
The researchers looked at both fatal and non-fatal “cardiovascular disease events”, including death from heart disease or stroke, non-fatal myocardial infarction (heart attack), coronary surgical procedures, stroke and heart failure.
The researchers took into account various factors linked with death from heart disease or stroke. These included age and sex, psychological distress and hospital stays for psychiatric conditions. This analysis took into account age, sex, initial mental health symptoms, lifestyle and demographic factors, high blood pressure and use of CVD medication
There was no increased risk of death from CVD, cancer or any cause from taking TCAs, SSRIs or other antidepressant medications in the adjusted analyses.
They note that, although depression and psychological distress are also risk factors for CVD, the fact that the participants were assessed for some symptoms of mental illness at the beginning of the study, and that these were taken into account in the analysis, suggests that the effect of TCAs on CVD may be independent of people’s mental health.
Overall, due to limitations relating to lack of information on how well people stuck to taking the antidepressants they were prescribed, or the fact that other risk factors such as smoking and drinking were not taken into account, or the fact that some people in the study may have developed cardiovascular disease during the course of the study or the fact that some people in the study may have developed cardiovascular disease during the course of the study, further alternative studies would need to be done in order to substantiate this study.
“By giving up smoking, losing weight, and becoming more active, people can reduce their risk of cardiovascular disease two- to three-fold, which largely outweighs the risks of taking the medications.” (See article on Heart Rhythm Meditation).
If tricylic anti-depressants do increase the risk of cardiovascular events, the increase in risk is likely to be relatively small compared to other avoidable risk factors; for example,the risk of cardiovascular disease from smoking or poor diet.