Can Antidepressants Raise Risk of Sudden Cardiac Death?

Patients who have used antidepressants face an increased risk of sudden cardiac death (SCD) compared to the general population, according to new findings presented at EHRA 2025, a scientific congress by the European Society of Cardiology. This risk varies with age and duration of antidepressant use (1^✔ ✔Trusted Source
Use of antidepressant medication linked to substantial increase in risk of sudden cardiac death

Go to source). Sudden cardiac death is an unexpected fatality believed to be caused by heart-related issues, occurring within one hour of symptom onset in witnessed cases or within 24 hours if the person was last seen alive. In younger individuals under 39, SCD is often triggered by heart muscle thickening or electrical disturbances. In older populations, the most common cause is the narrowing of the heart’s blood vessels.

Impact of Psychiatric Conditions on Sudden Cardiac Death

Studies have shown that individuals with psychiatric disorders face higher all-cause mortality rates, including double the risk of SCD across various age groups. However, the influence of antidepressant medication on the risk of SCD has remained unclear.

Researchers analyzed death data from Denmark, reviewing all death certificates and autopsy reports of residents aged 18-90 in 2010. SCD cases were categorized, and antidepressant use was determined based on prescription data over a 12-year period leading up to the year of follow-up (2010).

Increased Risk of Sudden Cardiac Death with Antidepressant Use

Out of 45,701 deaths in 2010, 6002 were due to SCD. Among the 643,999 residents who had used antidepressants, 1,981 of them suffered SCD. The incidence rate for SCD was significantly higher among those exposed to antidepressants, with the exception of those aged 18-29, where the association was not statistically significant.

When adjusted for age, sex, and comorbidities, individuals who used antidepressants for 1 to 5 years had a 56% increased risk of SCD compared to the unexposed population. Those with 6 or more years of antidepressant use had a 2.2 times higher risk.

Age-Related Changes in Sudden Cardiac Death Risk from Antidepressants

For individuals aged 30-39, those with 1 to 5 years of antidepressant exposure had a risk of SCD nearly three times higher, which increased to five times higher for those exposed for six or more years.

In individuals aged 50-59 years, those exposed to antidepressants for 1 to 5 years had their risk of SCD doubled. For those exposed for 6 or more years, the risk quadrupled.

The increased risk of SCD from antidepressant use decreased slightly in older age groups. In those aged 70-79 years, exposure to antidepressants for 1-5 years increased the SCD risk by 83%, while those exposed for longer (6+ years) saw a 2.2 times higher risk.

In those aged 40-79, the risk of SCD was notably higher for those with 6+ years of antidepressant use compared to those with 1-5 years. The risk increase varied by age group, with the greatest increase (70%) seen in those aged 40-49 years, and smaller increases in older groups. For individuals aged 39 or younger and those over 80, the difference in risk between the two groups was not statistically significant.

“Exposure time to antidepressants was associated with a higher risk of sudden cardiac death, and linked to how long the person had been exposed to antidepressants,” says study co-author Dr. Jasmin Mujkanovic, Rigshospitalet Hjertecentret, Copenhagen, Denmark. “Those exposed for 6 years or more were at even more increased risk than those exposed for 1 to 5 years, when compared with people unexposed to antidepressants in the general population.”

Behavioral and Lifestyle Factors Contributing to Sudden Cardiac Death Risk

On the potential reasons for the association, she adds: “The increased risk of sudden cardiac death may be attributed to the potential adverse effects of the antidepressants. However, the exposure time to antidepressants might also serve as a marker for more severe underlying illness. Additionally, the increase could be influenced by behavioural or lifestyle factors associated with depression, such as delayed healthcare seeking, and poor cardiovascular health. Further research is warranted.”

In conclusion, this research shows that long-term antidepressant use is linked to a higher risk of sudden cardiac death, especially for those who’ve been using them for six years or more. While the exact cause isn’t fully clear, factors like the medication’s side effects, underlying health issues, and lifestyle habits tied to depression may contribute.

Reference:

1. Use of antidepressant medication linked to substantial increase in risk of sudden cardiac death - (https://www.escardio.org/The-ESC/Press-Office/Press-releases/Use-of-antidepressant-medication-linked-to-substantial-increase-in-risk-of-sudden-cardiac-death)

Source-Medindia