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Use of antidepressants for 12 weeks or longer is associated with a reduced incidence of heart attack in depressed adults

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Are antidepressants associated with an increased or decreased risk of incident myocardial infarction (MI) and all-cause mortality?


93 653 patients aged 25–80 years (average age 51.5 years, 14.1% female, 77.8% White, 57.1% not married) identified using the US Department of Veterans Affairs database, who had either one inpatient or at least two outpatient codes for depression in their records between 1 October 1999 and 30 September 2000. Patients with at least one primary or secondary diagnosis of heart or cardiovascular disease, or with psychotic or bipolar disorders, were excluded. Patients were excluded from the analyses if a MI occurred within 1 month of follow-up; they did not receive a 12-week follow-up from baseline if they only had a diagnosis of dysthymia or psychotic disorders of bipolar disorder.


Veterans Health Administration, USA; 1999–2007.

Risk factors

12 weeks or longer of continuous antidepressant treatment with the same drug compared with 0–11 weeks of continuous antidepressant treatment. Antidepressant use was assessed using Pharmacy Benefits Management records, and the drug classified as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), …

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  • Sources of funding Veteran Administration Health Services Research and Development.


  • Competing interests None.

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