The use of antidepressants has increased in recent years and the most common are selective serotonin reuptake inhibitors (SSRIs), which block the reuptake of the neurotransmitter of “happiness”, serotonin. However, although they help people with depression, the long-term effects of these drugs are controversial.
For this reason, a team of scientists from McMaster University in Ontario (Canada) has studied the link between the use of antidepressants and the risk of mortality, through a meta-analysis of existing research from various medical databases, looking for a link between mortality and antidepressant use. The analysis included 16 studies, with approximately 375,000 participants.
They extracted data on cardiovascular disease, cardiovascular risk, and the type of antidepressants taken. They then used a mixed effects model to carry out their meta-analysis, controlling for depression and other illnesses.
“We made sure to only include studies that did a good enough job to control for important variables (such as depression and other illnesses), so we have tried to statistically rule out other factors that could contribute to mortality, ” explains Marta Maslej, leader from work.
The results revealed that, in the general population, people taking antidepressants had a 33% higher risk of dying prematurely than people not taking these drugs. Additionally, antidepressant users were 14% more likely to have an adverse cardiovascular event, such as a heart attack.
No significant differences were observed between SSRIs and tricyclic antidepressants (used to treat depression and disorders such as OCD or obsessive-compulsive disorder).
The results do not appear to suggest a negative effect of antidepressant medication in those with heart disease or diabetes, which is consistent with the hypothesis that, due to their anticoagulant properties, antidepressants may be helpful for people with cardiovascular disease, but harmful for healthy people.
The secundary effects
Experts say more studies are needed to look more deeply at how antidepressants work in the body. “We are very concerned about these results, they suggest that we should not take antidepressant medications without understanding exactly how they interact with the body”, clarifies Paul Andrews, co-author of the work.
“I prescribe antidepressants although I do not know if they are more harmful than useful in the long term. I am concerned that in some patients they may be, and psychiatrists in 50 years will wonder why we did not do more to find out,” adds Benoit Mulsant, also a co-author of the study. collected in the journal Psychotherapy and Psychosomatics.
However, it must be borne in mind that this is an observational study and, therefore, the experts could not draw conclusions about causation, but the authors believe that antidepressants disturb the functioning of monoamines (important biochemicals such as serotonin and dopamine), and these neurotransmitters have important functions not only in the brain, but throughout the body. “Disrupting the functioning of serotonin can therefore have different adverse effects, which can contribute to a risk of death in many different ways.”
Referencia: The Mortality and Myocardial Effects of Antidepressants Are Moderated by Preexisting Cardiovascular Disease: A Meta-Analysis. Psychotherapy and Psychosomatics 2017 doi.org/10.1159/000477940
