Antidepressant use and risk for mortality in 121,252 heart failure patients with or without a diagnosis of clinical depression
Open accessAbstract
Background Depression is a risk factor for mortality in patients with heart failure (HF), however, treating depression with antidepressant therapy does not seem to improve survival. We examined the prevalence of antidepressant use in HF patients, the correlates of antidepressant use subsequent to hospital discharge and the relation between antidepressant use, clinical depression and mortality in patients with HF.Methods 121,252 HF patients surviving first hospitalization were stratified by antidepressant use and a diagnosis of clinical depression.Results In total, 15.6% (19,348) received antidepressants at baseline, of which 86.7% (16,780) had no diagnosis of clinical depression. Female gender, older age, higher socio-economic status, more comorbidities, increased use of statins, spironolactone and aspirin, lower use of beta-blockers and ACE-inhibitors, greater HF severity and a diagnosis of clinical depression were independently associated with antidepressant use. Patients using no antidepressants with clinical depression and patients using antidepressants, with or without clinical depression, had a significantly higher risk for all-cause mortality (HR, 1.25; 95% CI, 1.15-1.36; HR, 1.24; 95% CI, 1.22-1.27; HR, 1.21; 95% CI, 1.16-1.27, respectively) and CV-mortality (HR: 1.17; 95% CI, 1.14-1.20, P<.001; HR: 1.20; 95% CI, 1.08-1.34, P<.001; HR: 1.21; 95% CI, 1.12-1.29, P<.001, respectively) as compared to patients not using antidepressants without depression in adjusted analysis.Conclusion Patients with HF taking antidepressants had an increased risk for all-cause and CV-mortality, irrespectively of having clinical depression. These results highlight the importance of further examining the antidepressant prescription pattern in patients with HF, as this may be crucial in understanding the antidepressant effects on cardiac function and mortality.
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All antidepressants may have some potential to increase mortality in relation to their use.
“As partly described in previous section, all antidepressants may have some potential to increase mortality in relation to their use.”
From Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review (2018) · cites this paper as [86]
Evidence has been consistent in relation with the increasing risk of all causes of mortality due to antidepressants use.
“Evidence has been consistent in relation with the increasing risk of all causes of mortality due to antidepressants use.86”
From Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review (2018) · cites this paper as [86]
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- Authors
- Brouwers, C., Christensen, S. B., Damen, N. L., Denollet, J., Torp-Pedersen, C., Gislason, G. H., & Pedersen, S. S.
- Affiliations
- Tilburg University (NL)
- Gentofte Hospital (DK)
- University of Copenhagen (DK)
- University of Southern Denmark (DK)
- Corresponding author
- Pedersen, Susanne S.
- ORCID
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2016-01
- Volume
- 203
- Pages
- 867-873
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2199554510
- Cited by
- 60
- References
- 26
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 4 · 2023: 6 · 2022: 6 · 2021: 4 · 2020: 7 · 2019: 7 · 2018: 6 · 2017: 8 · 2016: 5
- FWCI
- 4.61
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- International Journal of Cardiology (publishedVersion)
- Research portal (Tilburg University) (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- ZonMw
- Novo Nordisk Fonden
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- antidepressant use, heart failure, major depressive disorder, mortality, cardiovascular mortality, all-cause mortality, antidepressant prescribing patterns, comorbidities, beta-blockers, ACE inhibitors, spironolactone, statins, aspirin
- MeSH terms
- Aged, Antidepressive Agents, Denmark, Depression, Female, Follow-Up Studies, Heart Failure, Humans, Male, Netherlands, Retrospective Studies, Risk Factors, Survival Rate, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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