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    Antidepressants May Not Raise Heart Attack Risk

    Underlying Depression May Be the Problem, Says British Study

    Tracking Heart Attack Risk and Antidepressants

    The data came from more than 60,000 people who had had their first heart attack from 1988 through 2001. The cases were recorded in a British database of more than 8 million people.

    Each heart attack patient was compared with six similar people in the same database who had not had a heart attack. Prescription records showed which people had taken antidepressants.

    The researchers wanted to see whether the antidepressants affected heart attack risk, whether the risk differed between types of antidepressants, and whether the risk changed over time with antidepressants.

    Heart attacks occurred around age 70, on average. Most heart attack patients (61%) were men. As expected, smoking, high blood pressure, diabetes, and increased BMI (body mass index) were all heart attack risk factors.

    Heart Attack Risk Subsides

    Antidepressants were associated with an increased risk of heart attacks. But it wasn't quite that simple.

    Taking all risk factors into account, both tricyclic antidepressants and SSRIs were associated with an increased risk of a person's first heart attack. But the risk was higher for the first 28 days on either type of antidepressant. After that, the risk subsided, rising again for 29-56 days after the patients stopped taking antidepressants.

    "Reassuringly ... there was no increased risk of [heart attack] with prolonged antidepressant exposure," says the study.

    The researchers say they're not sure why the risk rose after patients stopped taking the drugs. They say it could be due to the drugs, but it could also be that patients quit the drugs as their heart problems worsened or developed other illnesses. More work is needed to sort that out, say the researchers, who included Laila Tata of England's Nottingham City Hospital.

    Their study appears in the April edition of the journal Heart.

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