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Higher Risk Of Stroke, Heart Attack Linked To Long-term Use Of Antidepressants

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The longest stringent studies of antidepressants’ safety and efficacy only followed patients for only a couple of years.

Yet a greater number of Americans are taking antidepressants like Paxil and Prozac for prolonged periods of time. According to data from the National Center for Health Statistics, a quarter of people on the medications have used them for a decade or more.

Antidepressants are one of the three most commonly used therapeutic drug classes in the United States[1]. While the majority of antidepressants are taken to treat depression, antidepressants can also be taken to treat other conditions, like anxiety disorders.

(I am sure I don’t have to tell you this, but just as a reminder, suddenly stopping your medication may worsen your depression. Please consult your care provider about discontinuing antidepressant medications before making any changes.)

Serotonin Effects

Those who used antidepressants had a 14% higher risk of heart attacks and strokes and a 33% greater risk of death, according to findings in a meta-analysis of 17 studies that was published in 2017[2].

Interestingly, in cardiovascular patients, antidepressant use had no significant affect on these risks.

Length of antidepressant use among persons aged 12 and over
Length of antidepressant use among persons aged 12 and over, by sex: United States, 2011–2014.
Credit: NCHS

Selective serotonin reuptake inhibitors (SSRIs), the most popular class of antidepressants, not only affect the action of the neurotransmitter serotonin in the brain, but also throughout the body. Since serotonin is involved in critical processes like growth, digestion and immune function, disrupting serotonin levels could have widespread negative health effects.

Antidepressant use increased nearly 65% over a 15-year time frame, from 7.7% in 1999–2002 to 12.7% in 2011–2014, according to the National Center for Health Statistics. This increase was similar among males and females. At every time point, females were about twice as likely as males to report antidepressant use in the past month.

There is a growing concern among health professionals that some people who are taking the drugs long-term shouldn’t be — needlessly subjecting themselves to side effects and potential health risks, a Wall Street Journal article reports.

[1] National Center for Health Statistics. Health, United States, 2015: With special feature on racial and ethnic health disparities. Table 80: Selected prescription drug classes used in the past 30 days, by sex and age: United States, selected years 1988–1994 through 2009–2012. Hyattsville, MD. 2016.

[2] Maslej M.M., Bolker B.M., Russell M.J., Eaton K., Durisko Z., Hollon S.D., Swanson G.M., Thomson Jr. J.A., Mulsant B.H., Andrews P.W. The Mortality and Myocardial Effects of Antidepressants Are Moderated by Preexisting Cardiovascular Disease: A Meta-Analysis. Psychother Psychosom. 2017;86(5):268-282. doi: 10.1159/000477940