Antidepressant drug compliance

Reduced risk of MI and mortality in depressed patients

Jeffrey F. Scherrer, Lauren D. Garfield, Patrick J. Lustman, Paul Hauptman, Timothy Chrusciel, Angelique Zeringue, Robert M. Carney, Kenneth E. Freedland, Kathleen K. Bucholz, Richard Owen, John W. Newcomer, William R. True

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background: The long-term risk of myocardial infarction (MI) associated with use of antidepressants is uncertain, especially for nontricyclic antidepressants. The present study uses a national Veterans Affairs cohort to test whether antidepressants increase or decrease risk of MI and all-cause mortality. Methods: US Department of Veterans Affairs patient records were analyzed to identify a cohort free of cardiovascular disease in fiscal years 1999 and 2000, aged 25-80 years, who had an International Classification of Diseases, Ninth Revision, Clinical Modification code indicating an episode of depression (n = 93,653). Incident MI and all-cause mortality were modeled in patients who received 12 weeks or more of antidepressant pharmacotherapy as compared with 0-11 weeks during follow-up. Age-adjusted Cox proportional hazard models were computed before and after adjusting for baseline sociodemographics and time-dependent covariates. Results: Receipt of 12 or more weeks of continuous antidepressant therapy was associated with significantly reduced rates of incident MI across classes of antidepressants: selective serotonin reuptake inhibitor (SSRIs) (hazard ratio [HR] 0.48; 95% confidence interval [CI], 0.44-0.52), serotonin-norepinephrine reuptake inhibitors (SNRIs) (HR 0.35; 95% CI, 0.32-0.40), tricyclic antidepressants (TCAs) (HR 0.39; 95% CI, 0.34-0.44), and "Other" (HR 0.41; 95% CI, 0.37-0.45). Risk of all-cause mortality also was decreased with receipt of 12 weeks of pharmacotherapy with all classes of antidepressants (SSRI, SNRI, TCA, Other), with HRs ranging from 0.50 to 0.66. Conclusions: Across classes of antidepressants, 12 weeks of pharmacotherapy appears to be safe in terms of MI risk. Although the mechanism for this association remains uncertain, it is possible that compliance with pharmacotherapy for depression reflects compliance with cardiovascular medications. It also is possible that a direct drug effect or improved depressed mood may attenuate the risk of MI in depressed patients.

Original languageEnglish (US)
Pages (from-to)318-324
Number of pages7
JournalAmerican Journal of Medicine
Volume124
Issue number4
DOIs
StatePublished - Apr 1 2011
Externally publishedYes

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Antidepressive Agents
Compliance
Myocardial Infarction
Mortality
Confidence Intervals
Drug Therapy
Tricyclic Antidepressive Agents
Serotonin Uptake Inhibitors
Depression
United States Department of Veterans Affairs
International Classification of Diseases
Veterans
Proportional Hazards Models
Cardiovascular Diseases
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Scherrer, J. F., Garfield, L. D., Lustman, P. J., Hauptman, P., Chrusciel, T., Zeringue, A., ... True, W. R. (2011). Antidepressant drug compliance: Reduced risk of MI and mortality in depressed patients. American Journal of Medicine, 124(4), 318-324. https://doi.org/10.1016/j.amjmed.2010.11.015

Antidepressant drug compliance : Reduced risk of MI and mortality in depressed patients. / Scherrer, Jeffrey F.; Garfield, Lauren D.; Lustman, Patrick J.; Hauptman, Paul; Chrusciel, Timothy; Zeringue, Angelique; Carney, Robert M.; Freedland, Kenneth E.; Bucholz, Kathleen K.; Owen, Richard; Newcomer, John W.; True, William R.

In: American Journal of Medicine, Vol. 124, No. 4, 01.04.2011, p. 318-324.

Research output: Contribution to journalArticle

Scherrer, JF, Garfield, LD, Lustman, PJ, Hauptman, P, Chrusciel, T, Zeringue, A, Carney, RM, Freedland, KE, Bucholz, KK, Owen, R, Newcomer, JW & True, WR 2011, 'Antidepressant drug compliance: Reduced risk of MI and mortality in depressed patients', American Journal of Medicine, vol. 124, no. 4, pp. 318-324. https://doi.org/10.1016/j.amjmed.2010.11.015
Scherrer, Jeffrey F. ; Garfield, Lauren D. ; Lustman, Patrick J. ; Hauptman, Paul ; Chrusciel, Timothy ; Zeringue, Angelique ; Carney, Robert M. ; Freedland, Kenneth E. ; Bucholz, Kathleen K. ; Owen, Richard ; Newcomer, John W. ; True, William R. / Antidepressant drug compliance : Reduced risk of MI and mortality in depressed patients. In: American Journal of Medicine. 2011 ; Vol. 124, No. 4. pp. 318-324.
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AU - Chrusciel, Timothy

AU - Zeringue, Angelique

AU - Carney, Robert M.

AU - Freedland, Kenneth E.

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