title: Antidepressant use and risk of out-of-hospital cardiac arrest: a nationwide case-time-control study.
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.
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark. pw@heart.dk
authors.forename: P
authors.initials: P
authors.lastname: Weeke
authors.forename: A
authors.initials: A
authors.lastname: Jensen
authors.forename: F
authors.initials: F
authors.lastname: Folke
authors.forename: G H
authors.initials: GH
authors.lastname: Gislason
authors.forename: J B
authors.initials: JB
authors.lastname: Olesen
authors.forename: C
authors.initials: C
authors.lastname: Andersson
authors.forename: E L
authors.initials: EL
authors.lastname: Fosbøl
authors.forename: J K
authors.initials: JK
authors.lastname: Larsen
authors.forename: F K
authors.initials: FK
authors.lastname: Lippert
authors.forename: S L
authors.initials: SL
authors.lastname: Nielsen
authors.forename: T
authors.initials: T
authors.lastname: Gerds
authors.forename: P K
authors.initials: PK
authors.lastname: Andersen
authors.forename: J K
authors.initials: JK
authors.lastname: Kanters
authors.forename: H E
authors.initials: HE
authors.lastname: Poulsen
authors.forename: S
authors.initials: S
authors.lastname: Pehrson
authors.forename: L
authors.initials: L
authors.lastname: Køber
authors.forename: C
authors.initials: C
authors.lastname: Torp-Pedersen
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects / Q000145:classification; D016022:Case-Control Studies; D015283:Citalopram / Q000008:administration & dosage / Q000009:adverse effects*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D003718:Denmark; D003863:Depression / Q000188:drug therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009661:Nortriptyline / Q000008:administration & dosage / Q000009:adverse effects*; D016017:Odds Ratio; D058687:Out-of-Hospital Cardiac Arrest / Q000139:chemically induced* / Q000453:epidemiology; D018570:Risk Assessment; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents; D015283:Citalopram; D009661:Nortriptyline