Antidepressant Use and Risk of Out-of-Hospital Cardiac Arrest: A Nationwide Case–Time–Control Study
Clinical Pharmacology & Therapeutics, 05/21/2012
Weeke P et al. – An association between cardiac arrest and antidepressant use could be documented in both the selective serotonin reuptake inhibitor and tricyclic antidepressant classes of drugs.Methods
- 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.
- The authors 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).