Long-term use of antidepressants may increase the risk of suffering from heart disease and death, scientists say.
Researchers at the University of Bristol found that patients who had been taking the drug for more than 10 years were twice as likely to have a heart attack and die.
One in six adults in England and one in five in the US take drugs, which are thought to increase levels of chemicals in the brain that boost mood.
Despite the discovery, academics urged the millions who are taking the pills today not to panic, stressing that they are still safe to take.
The link they see may be in depression pushing up the risk of heart problems rather than the drugs themselves.
Researchers at the University of Bristol found that those who had been taking the drug for more than 10 years were more likely to be diagnosed with and die from heart disease.
The team led by Dr. Narendra Bansal compared the health of those who took antidepressants with those who did not for more than 10 years. They looked at eight types of drugs, all of which are withdrawn by the NHS. These include selective serotonin reuptake inhibitors (SSRIs) citalopram (top picture), sertraline (second picture), fluoxetine and paroxetine. Eight out of 10 people who use antidepressants in the UK take one of these medicines
What is depression?
Although it is normal to feel down from time to time, people with depression may feel constantly sad for weeks or months on end.
Depression can affect anyone at any age and is quite common – around one in ten people are likely to experience it at some point in their lives.
Depression is a real health condition that people cannot ignore or ‘snap out of’.
Symptoms and effects vary, but may include feeling persistently depressed or hopeless, or losing interest in things you used to enjoy.
It can also cause physical symptoms such as sleep problems, fatigue, low appetite or sex drive, and even physical pain.
In extreme cases it can lead to suicidal thoughts.
Traumatic events can trigger it, and people with a family history may be more at risk.
It’s important to see a doctor if you think you or someone you know may have depression, as it can be managed with lifestyle changes, therapy, or medication.
Source: NHS Choices
To find out whether antidepressant use affects heart health, researchers examined data from 220,121 people aged 40 to 69 in the UK Biobank – a database containing the health records of half a million Britons.
The team, led by Dr Narendra Bansal, compared the health of people who took antidepressants with those who did not for more than 10 years.
They looked at eight types of drugs, all of which are withdrawn by the NHS.
These included the selective serotonin reuptake inhibitors (SSRIs) citalopram, sertraline, fluoxetine and paroxetine.
Eight out of 10 people who use antidepressants in the UK take one of these medicines.
They also looked at four other antidepressants: mirtazapine, venlafaxine, duloxetine and trazodone.
The results, published in the British Journal of Psychiatry Open, showed that those taking SSRIs were 34 percent more likely to have a heart attack than those not taking any antidepressant.
Users were nearly twice as likely to die from heart disease and 73 percent more likely to die prematurely from any cause.
For those taking the other four antidepressants, the risk was twice as high as for those not taking the drugs.
The team also found that antidepressants, particularly SSRIs, were associated with a 23 to 32 percent lower risk of developing high blood pressure or diabetes. However, they noted that this finding requires further research.
The researchers said: ‘Antidepressants, and SSRIs in particular, may have a good safety profile in the short term, but are associated with adverse outcomes in the long term.
‘This is important because much of the increase in prescribing over the past 20 or so years has been in long-term repeat prescribing.’
However, Dr Bansal urged people not to suddenly stop taking their medication – advising them to speak to their GP if they have concerns.
He noted that the researchers took into account a wide range of risk factors — including that those with depression were more likely to be overweight, smoke and exercise less.
But Dr Bansal said it was ‘difficult to fully control the effects of depression’.
‘This makes it difficult to completely separate the effects of depression from the effects of medication,’ she said.
For example, those taking four antidepressants without an SSRI may have ‘more severe depression’, which may explain their higher rates of poor health.
Dr Bansal added: ‘Further research is needed to assess whether the associations we observed are indeed due to the drug, and if so, why this might be.
‘In the meantime, our message to clinicians is that long-term prescribing of antidepressants may not be harmless.’
She called for ‘proactive cardiovascular monitoring’ in patients on long-term antidepressant medication, ‘both of which are associated with increased risk’.
NHS figures show 8.3 million patients were prescribed antidepressants in England last year, up six per cent on 7.9 million a year earlier.
Prescriptions of antidepressant drugs among teenagers in England rose by a quarter in 2020 compared to 2016. The biggest increase was seen among 13- and 19-year-olds, where prescription rates rose by nearly a third.
Young adults, who are often leaving home for the first time and starting their careers, also saw antidepressant prescription rates rise by nearly 40 percent.
In 2019, research looking at nearly 1,000 existing studies published in JAMA Psychiatry concluded that antidepressants are generally safe.
Professor Glynn Lewis, a psychiatrist at University College London, said people should not be ‘worried or alarmed’ by the findings, or stop taking their medication.
He said the study could not conclude whether depression increases health risks or the use of antidepressants.
“There is a lot of evidence from other research that depression is associated with increased heart disease,” he said.
‘Obviously, there are behavioral things (related to depression), where people may not take care of themselves, and there may also be hormonal changes and metabolic changes that can increase the risk of physical illnesses in the long term.
‘Without randomized controlled trials, it’s always really, really hard to make any inferences about whether it’s the antidepressants or the depression that’s causing this kind of association.’
Professor David Osborne, Psychiatry Professor at UCL, said: ‘We’ve known that depression and anxiety have been associated with increased rates of heart disease for many years.
‘It explains the findings in this interesting paper but there is no evidence of a causal role for antidepressants. More detailed research methods are needed to prove causation.’
Professor Martin Marshall, president of the Royal College of GPs, said: ‘The available evidence shows that antidepressants can be an effective treatment for the painful and often debilitating symptoms of anxiety and depression when used appropriately.
‘GPs are highly trained to have open and sensitive conversations with their patients, and when discussing mental health concerns they will consider different treatment options based on the patient’s unique needs, and if antidepressants are prescribed, it will usually be at the lowest dose. For the shortest time.
‘This is an interesting study and as the authors point out, more research is needed in this area.
‘However, it is really important that patients do not stop taking their prescribed antidepressants as a result of this research, but if they are concerned, they should discuss this at their next medication review.’
Source: | This article is originally from Dailymail.co.uk