Antidepressant Use Associated with Increased Risk of Sudden Cardiac Death

Recent studies have unveiled a concerning correlation between the use of antidepressant medications and a heightened risk of sudden cardiac death (SCD). Sudden cardiac death, characterized by an unexpected demise attributed to heart-related issues, typically occurs within an hour of symptom onset or within 24 hours of the last sighting of the individual.

In younger populations, particularly those under 39, causes of SCD often include heart muscle thickening or electrical disturbances in the heart. Conversely, in older adults, the primary culprits tend to be narrowing blood vessels that supply the heart. Prior research has indicated that individuals with psychiatric disorders face significantly higher all-cause mortality rates, including a doubling of the risk for sudden cardiac death across various age groups. However, the specific impact of antidepressant exposure on SCD risk has remained ambiguous until now.

New findings presented at the EHRA 2025 scientific congress, organized by the European Society of Cardiology, demonstrate that individuals with a history of antidepressant use exhibit a significantly increased risk of SCD compared to those without such a history. This risk appears to vary based on age and duration of antidepressant exposure.

The research involved a comprehensive examination of mortality records in Denmark, focusing on residents aged 18 to 90 years during 2010. Researchers meticulously reviewed death certificates and autopsy reports, categorizing deaths as either SCD or non-SCD based on the available data. Antidepressant exposure was determined by individuals who redeemed prescriptions for these medications at least twice within a year over a 12-year period prior to the follow-up year.

Among the 4.3 million residents analyzed, a total of 45,701 deaths were recorded, including 6,002 instances of SCD. Notably, 643,999 individuals had previously been prescribed antidepressants. Within this cohort, 1,981 cases of sudden cardiac death were documented, contrasting with 4,021 cases in the unexposed general population.

The incidence rate of SCD was notably higher among those who had been exposed to antidepressants across all age groups, with the exception of the 18-29 age bracket, where the association did not reach statistical significance. After adjusting for variables such as age, sex, and existing health conditions, individuals with one to five years of antidepressant use exhibited a 56% increased risk of SCD compared to unexposed individuals. This risk escalated to 2.2 times higher for those with six or more years of exposure.

For individuals aged 30 to 39, the risk of sudden cardiac death was approximately three times greater for those with one to five years of antidepressant exposure, escalating to five times higher for those with six or more years. Similarly, individuals aged 50 to 59 showed a doubled risk with one to five years of exposure, while those with six or more years faced a quadrupled risk.

The differences in risk associated with varying durations of antidepressant exposure lessened in older age groups. For those aged 70 to 79, the risk of SCD increased by 83% for individuals with one to five years of exposure compared to unexposed individuals, while those with six or more years of exposure had a 2.2 times heightened risk.

Dr. Jasmin Mujkanovic, a co-author of the study, noted that the duration of exposure to antidepressants is linked to higher SCD risk, indicating that those with longer exposure face significantly increased hazards when compared to unexposed individuals. She highlighted that the increased risk may stem from the potential adverse effects of antidepressants or may reflect a more serious underlying medical condition. Behavioral and lifestyle factors associated with depression, such as delayed healthcare seeking and poor cardiovascular health, could also play a role, warranting further investigation.