Long-Term Antidepressant Use May Increase Sudden Cardiac Death Risk
New study links extended antidepressant use with elevated risk for heart-related death, though experts caution against stopping treatment without medical advice.
Topline:
A large Danish study suggests that individuals using antidepressants for six or more years may face more than double the risk of sudden cardiac death (SCD) compared to non-users, although depression itself remains a major cardiovascular risk factor.
Study Details
The study, presented at the European Heart Rhythm Association 2025 congress, aimed to clarify the debated link between long-term antidepressant use and sudden cardiac death. Prior studies had hinted at a cardiovascular impact from both depression and psychiatric medications, but this research uniquely assessed how antidepressant exposure duration might affect outcomes.
Investigators reviewed all Danish death certificates and autopsy reports from 2010—a year with complete mortality data—to analyze cause-specific mortality across 4.3 million people aged 18 to 90.
Methodology
Antidepressant exposure was defined as at least two prescriptions in a year during the 12 years before 2010. Subjects were grouped into:
Short-term use (1–5 years)
Long-term use (6+ years)
Deaths were classified as either sudden cardiac death or non-SCD. Researchers adjusted for age, sex, and comorbidities such as ischemic heart disease and diabetes to isolate the effects of antidepressant duration.
Key Findings
Overall SCD risk was 56% higher in individuals with 1–5 years of antidepressant use and more than 2x higher in those using them for 6+ years, compared to non-users.
Age-specific risk was most pronounced in the 40–69 age range, with incidence rate ratios up to 2.0.
No significant risk was found in the 18–29 age group.
The study did not differentiate between antidepressant classes (e.g., SSRIs vs. tricyclics) or sex-based effects.
Depression itself increases the risk of cardiac death, which may partly explain the association.
Implications for Practice
For patients:
This study does not suggest stopping antidepressants, especially if they are improving quality of life. Depression is independently linked to a shorter life expectancy and higher cardiac risk. The best course of action is to speak with your doctor before making any medication changes.
For clinicians:
Long-term antidepressant use may signal higher risk for SCD, especially in middle-aged adults. Consider cardiovascular health monitoring in patients on chronic antidepressant therapy. Also, explore whether lifestyle interventions or medication adjustments could reduce risk, particularly in those with multiple comorbidities.