Long-term use of antidepressants can increase the risk of heart disease and death, scientists say.
University of Bristol researchers found patients who had taken the drug for more than 10 years were twice as likely to be diagnosed and die from heart disease.
About one in six adults in the UK and one in five in the US take the drug, which is thought to increase levels of chemicals in the brain that improve mood.
Despite this finding, scientists today have urged millions of people taking the pill not to panic and insist they are still safe to take.
The link they found may be due to depression itself increasing the risk of heart problems, not the medication itself.
Researchers at the University of Bristol found that people who have been taking the drug for more than 10 years are more likely to be diagnosed with and die from heart disease.
The team, led by Dr. Narinder Bansal, compared the health of people taking antidepressants with those who hadn’t passed 10 years. They looked at eight drugs, all distributed by the NHS. These include the selective serotonin reuptake inhibitors (SSRIs) citalopram (top figure), sertraline (second figure), fluoxetine, and paroxetine. Around 8 in 10 people taking antidepressants in the UK take one of these
To determine whether antidepressant use affects heart health, researchers examined data on 220,121 people aged 40 to 69 at the UK Biobank – a database contains the health records of half a million Britons.
The team, led by Dr. Narinder Bansal, compared the health of people taking antidepressants with those who hadn’t passed 10 years.
They looked at eight drugs, all distributed by the NHS.
These include the selective serotonin reuptake inhibitors (SSRIs) citalopram, sertraline, fluoxetine, and paroxetine.
Around eight in 10 people taking antidepressants in the UK take one of these.
They also looked at four other antidepressants: mirtazapine, venlafaxine, duloxetine, and trazodone.
Results published in the British Journal of Open Psychiatry showed that people taking SSRIs had a 34 per cent higher risk of heart disease than those not taking any antidepressants.
Users were nearly twice as likely to die from cardiovascular disease and 73% more likely to die prematurely from any cause.
For those taking the other four antidepressants, the risk was more than double that of those who didn’t.
The team also found that antidepressants, particularly SSRIs, were associated with a 23 to 32 percent reduction in the risk of developing high blood pressure or diabetes. However, they note that this finding needs further study.
‘Antidepressants, and especially SSRIs, may have good short-term safety, but are associated with adverse long-term outcomes, the researchers said.
‘This is important because most of the significant increase in prescribing over the past 20 years has been due to repeat prescribing over long periods of time.’
However, Dr. Bansal advises people not to suddenly stop taking their medication – advising them to talk to their GP if they are concerned.
She noted that the researchers took into account a range of risk factors – including that people with depression were more likely to be overweight, smoked and exercised less.
But Dr. Bansal says it’s difficult to fully control the impact of depression.
“This makes it very difficult to completely separate the effects of depression from the effects of medication,” she said.
For example, people taking four non-SSRI antidepressants ‘may have more severe depression’, which may explain their higher rates of poor health.
Dr Bansal added: ‘Further research is needed to assess whether the associations we have seen are indeed due to the drug, and if so, why.
‘In the meantime, our message to clinicians is that long-term antidepressant prescriptions may not be harmless.’
She called for ‘proactive cardiovascular monitoring’ in patients who are on long-term antidepressants, ‘as both are associated with a higher risk’.
NHS figures show 8.3 million patients in the UK were prescribed antidepressants last year, up 6% from 7.9 million a year earlier.
Prescriptions of antidepressants among teenagers have increased by a quarter in the UK in 2020 compared to 2016. The strongest growth has been among 13 and 19 year olds, where prescribing rates increased by around a third.
Young adults, who often leave home for the first time and start their careers also see an explosion in antidepressant prescription rates of around 40%.
In 2019, a review of about 1,000 existing studies, published in JAMA Psychiatry, concluded that antidepressants are generally safe.
Professor Glyn Lewis, a psychiatrist at University College London said people should not be ‘panic or alarmed’ by the findings, or stop taking their medication.
He said the study could not conclude whether it was depression that increased health risks or the use of antidepressants.
“There is a lot of evidence from other studies showing that depression is associated with an increase in cardiovascular disease,” he said.
‘Clearly, there are behavioral (related to depression) things where people may not be taking care of themselves and there may also be hormonal changes and possible metabolic changes increases the risk of long-term physical illness.
‘Without (randomized controlled trial), it’s always been really difficult to make any inferences as to whether it’s the antidepressant or the depression that’s driving these kinds of associations.’
Professor David Osborn, a psychiatrist at UCL, said: ‘We’ve known that depression and anxiety are associated with increased rates of cardiovascular disease over many years.
‘This explains the findings in this interesting paper but there is no evidence here of a causal role for antidepressants. Proving causality will require more sophisticated research methods. ‘
Professor Martin Marshall, President of the Royal College of Physicians, said: ‘Existing evidence suggests that antidepressants can be an effective treatment for the symptoms of anxiety and depression that often cause depression. grief and weakness when used appropriately.
‘General practitioners are intensively trained to have open and sensitive conversations with their patients, and when discussing mental health concerns, they consider treatment options. Treatment varies based on the individual needs of the patient and, if an antidepressant is prescribed, usually at the lowest dose and for the shortest amount of time.
‘This is an interesting study and as the authors outline, further research is needed in this area.
‘However, it is really important that patients do not stop taking their prescribed antidepressants as a result of this study, but if they are concerned they should discuss this during the review. next medicine.’
Source: | This article originally belonged to Dailymail.co.uk
