Antidepressant Use Linked to Higher Death Rates among ICU Patients

Antidepressant Use Linked to Higher Death Rates among ICU PatientsA new study is questioning the use of certain antidepressants, serotonin and norepinephrine reuptake inhibitor (SNRI) or serotonin reuptake inhibitors (SSRI), among seriously ill patients. The study, which was conducted by researchers from the Beth Israel Deaconess Medical Center in Boston and Massachusetts Institute of Technology (MIT), found that ICU patients who were being treated with SSRI antidepressants or SNRIs prior to admission had higher rates of mortality than ICU patients who had not been taking an antidepressant. Antidepressant patients admitted to the ICU for cardiac ailments appeared to have the highest risk of death.

SSRI antidepressants include the drugs Paxil, Prozac, Celexa, Lexapro and Zoloft. SSNRIs include Effexor, Pristiq and Cymbalta. Both SSRI and SNRI antidepressants increase serotonin levels in the brain, while SNRIs also increase brain levels of norepinephrine.

This new study examined records of 10,568 people that either died in the hospital or within a year of being in the ICU. Of that group, 1,876 were being treated with either an SSRI or SNRI antidepressant prior to their admission. According to the research team, patients using SSRIs or SSNRs were 73 percent more likely to die either in the hospital or during the first year following their time in the ICU compared to the patients who weren’t taking antidepressants.

Among heart surgery patients or those with heart problems, the mortality rate was double compared to other patient groups

The study authors conceded that their findings aren’t enough to make a definitive statement that antidepressants shouldn’t be taken by chronically ill heart patients. However, the findings do indicate that more research in this area is needed.

“Major depression is a common disorder affecting more than 16 percent of adults in the United States, and SSRIs are the most commonly prescribed medication class for this disease,” said Katherine. M. Berg, MD, one of the physicians involved in the study, said in a statement. “The benefits of SSRIs for the treatment of depression are well documented. Due to the practical limitations of clinical trials, however, the long-term risks are unknown.”

The study was presented at the American Thoracic Society 2012 International Conference in San Francisco on May 22, 2012.

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