title: Anti-depressant medication use and C-reactive protein: results from two population-based studies.
abstract: The use of anti-depressant medication has been linked to cardiovascular disease (CVD). We examined the association between anti-depressant medication use and a marker of low grade systemic inflammation as a potential pathway linking anti-depressant use and CVD in two population based studies. Data were collected in a representative sample of 8131 community dwelling adults (aged 47.4±15.9 years, 46.7% male) from the Scottish Health Surveys (SHS). The use of anti-depressant medication was coded according to the British National Formulary and blood was drawn for the measurement of C-reactive protein (CRP). In a second study, we attempted to replicate our findings using longitudinal data from the Whitehall II study (n=4584, aged 55.5±5.9 years, mean follow-up 5.5 years). Antidepressants were used in 5.6% of the SHS sample, with selective serotonin reuptake inhibitors (SSRIs) being the most common. There was a higher risk of elevated CRP (>3 mg/L) in users of tricyclic antidepressant (TCA) medication (multivariate adjusted odds ratio (OR)=1.52, 95% CI, 1.07-2.15), but not in SSRI users (multivariate adjusted OR=1.07, 95% CI, 0.81-1.42). A longitudinal association between any antidepressant use and subsequent CRP was confirmed in the Whitehall cohort. In summary, the use of anti-depressants was associated with elevated levels of systemic inflammation independently from the symptoms of mental illness and cardiovascular co-morbidity. This might be a potential mechanism through which antidepressant medication increases CVD risk. Further data are required to explore the effects of dosage and duration of antidepressant treatment.
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK. m.hamer@ucl.ac.uk
authors.forename: Mark
authors.initials: M
authors.lastname: Hamer
authors.forename: G D
authors.initials: GD
authors.lastname: Batty
authors.forename: Michael G
authors.initials: MG
authors.lastname: Marmot
authors.forename: Archana
authors.initials: A
authors.lastname: Singh-Manoux
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects*; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015331:Cohort Studies; D003866:Depressive Disorder / Q000188:drug therapy; D004363:Drug Utilization; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011153:Population; D011446:Prospective Studies; D012044:Regression Analysis; D012606:Scotland / Q000453:epidemiology; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects
chemical_list: D000928:Antidepressive Agents; D000929:Antidepressive Agents, Tricyclic; D015415:Biomarkers; D002097:C-Reactive Protein; D017367:Selective Serotonin Reuptake Inhibitors