L J Tata, J West, C Smith, P Farrington, T Card, L Smeeth, and R Hubbard

General population based study of the impact of tricyclic and selective serotonin reuptake inhibitor antidepressants on the risk of acute myocardial infarction
Heart 2005; 91: 465-471 [Abstract] [Full text] [PDF]

laila.tata{at}nottingham.ac.uk LJ Tata

We agree that the lack of drug specificity indicates that other factors, such as those relating to underlying depression, may explain the associations we have found with myocardial infarction. If amelioration of depression reduces the risk of myocardial infarction, then, yes, antidepressants may reduce the risk of later MI. Our data indicate that people with remaining time on antidepressants for a longer period than 28 days do have a lower point estimate risk of MI, however the confidence intervals for these risk estimates crossed 1.

almirtav.bh{at}terra.com.br Almir Tavares

The lack of difference between the size of the effects associated with tricyclic and selective serotonin reuptake inhibitor antidepressants points to some intrinsic characteristic of the underlying depressive disorder which determined the increased risk of myocardial infarction. Actually, these antidepressants may even have reduced the risk of myocardial infarction later.