Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb;29(2):469-477.
doi: 10.1111/ene.15137. Epub 2021 Oct 25.

Antidepressant use and stroke or mortality risk in the elderly

Begüm Irmak Ön  1 , Xavier Vidal  2 , Ursula Berger  1 , Mònica Sabaté  2 , Elena Ballarín  2 , Olga Maisterra  3 , Antonio San-Jose  4 , Luisa Ibáñez  2
Affiliations

Antidepressant use and stroke or mortality risk in the elderly

Begüm Irmak Ön et al. Eur J Neurol. 2022 Feb.

Abstract

Background and purpose: Current evidence on antidepressant-related stroke or mortality risk is inconsistent. Because the elderly have the highest exposure to antidepressants, the aim was to quantify their association with stroke and mortality risks in this vulnerable population.

Methods: Persons over 65 years old and registered in the Information System for Research in Primary Care of Catalonia during 2010-2015 comprised the study population. Antidepressant exposure was categorized into current-users, recent-users, past-users and antidepressant non-users (controls). The effect of antidepressant exposure on stroke or death, whichever came first, was analyzed by Cox regression adjusted for established risk factors.

Results: Of the 1,068,117 participants included, 20% had antidepressant reimbursements during follow-up, 17% had a stroke and 3% died. The risk of experiencing stroke or death was higher in antidepressant current-users (hazard ratio [HR] 1.04; 95% confidence interval [CI] 1.02-1.06), recent-users (HR 3.34; 95% CI 3.27-3.41) and past-users (HR 2.06; 95% CI 2.02-2.10) compared to antidepressant non-users. Antidepressant current-use was associated with increased stroke (HR 1.56; 95% CI 1.50-1.61) but decreased mortality risk (HR 0.93; 95% CI 0.91-0.94). During antidepressant recent-use and past-use, both stroke and mortality risks were significantly increased compared to no antidepressant use.

Conclusions: Antidepressant use may be associated with increased stroke risk in the elderly. When using antidepressants in this population, the potential risks should be considered.

Keywords: aged; antidepressive agents; mortality; pharmacoepidemiology; stroke.

PubMed Disclaimer

References

REFERENCES

    1. Abbing-Karahagopian V, Huerta C, Souverein PC, et al. Antidepressant prescribing in five European countries: application of common definitions to assess the prevalence, clinical observations, and methodological implications. Eur J Clin Pharmacol. 2014;70(7):849-857. https://doi.org/10.1007/s00228-014-1676-z
    1. Gomez-Lumbreras A, Ferrer P, Ballarín E, et al. Study of antidepressant use in 5 European settings. Could economic, sociodemographic and cultural determinants be related to their use? J Affect Disord. 2019;249:278-285. https://doi.org/10.1016/j.jad.2019.01.039
    1. Carrasco-Garrido P, López de Andrés A, Hernández Barrera V, Jiménez-Trujillo I, Jiménez-García R. National trends (2003-2009) and factors related to psychotropic medication use in community-dwelling elderly population. Int Psychogeriatr. 2013;25(2):328-338. https://doi.org/10.1017/S104161021200169X
    1. Schwarz S, Frölich L. Depression. In: Wehling M, ed. Drug Therapy for the Elderly. Springer-Verlag; 2013:197-213.
    1. Tham A, Jonsson U, Andersson G, Soderlund A, Allard P, Bertilsson G. Efficacy and tolerability of antidepressants in people aged 65 years or older with major depressive disorder-a systematic review and a meta-analysis. J Affect Disord. 2016;205:1-12. https://doi.org/10.1016/j.jad.2016.06.013

Publication types

Substances

LinkOut - more resources