Antidepressant Use and Risk of Out-of-Hospital Cardiac Arrest: A Nationwide Case-Time-Control Study

Research output: Contribution to journalJournal articleResearchpeer-review

P Weeke, Aksel Karl Georg Jensen, F Folke, G H Gislason, J B Olesen, C Andersson, E L Fosbøl, J K Larsen, Freddy Lippert, S L Nielsen, Thomas Alexander Gerds, Per Kragh Andersen, Jørgen K. Kanters, H E Poulsen, S Pehrson, L Køber, C Torp-Pedersen

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.
Original languageEnglish
JournalClinical Pharmacology and Therapeutics
Volume92
Issue number1
Pages (from-to)72-79
Number of pages8
ISSN0009-9236
DOIs
Publication statusPublished - 2012

ID: 40155476