Tricyclic antidepressants such as amitriptyline, desipramine, and doxepin, may harm your heart, according to a new study conducted by researchers at University College London (UCL). This risk may extend beyond individuals who are being treated for depression, as these older antidepressants are also used to treat anxiety, sleep problems, headache, and back pain, among other conditions.
Although tricyclic antidepressants are one of the oldest classes of antidepressants, they are still used extensively, according to eMedExpert. Today, selective serotonin reuptake inhibitors (SSRIs) have replaced tricyclics as the treatment of choice for depressive disorders, primarily because patients tolerate them better and they are safer if taken in excess.
Researchers at University College London compared the use of tricyclic antidepressants with SSRIs or no antidepressant use in nearly 15,000 individuals in Scotland. Overall, the older antidepressants were linked with a 35 percent increased risk of cardiovascular disease, while use of SSRIs was not.
Based on these findings, Dr. Mark Hamer, senior research fellow in the Department of Epidemiology and Public Health at UCL remarked that they “suggest that there is an association between the use of tricyclic antidepressants and an increased risk of CVD that is not explained by existing mental illness.” The study results thus indicate that tricyclics have properties that are responsible for the greater risk.
Previous research has shown tricyclic use to be associated with a significantly higher rate of serious cardiovascular side effects, such as increased heart rate, as well as arrhythmias, blood pressure abnormalities, and congestive heart failure. They have also been linked with weight gain and diabetes, which are risk factors for cardiovascular disease.
The UCL study’s authors note that other factors may be involved in the possible link between tricyclic antidepressant use and cardiovascular disease. Hamer pointed out that individuals who take antidepressants are more likely to be overweight, smoke, and not get sufficient exercise, also risk factors for cardiovascular disease.
Before it can be determined with more certainty that tricyclic antidepressants can harm the heart, “there needs to be more research looking closely at the effects of these drugs on your heart,” notes Amy Thompson, senior cardiac nurse at the British Heart Foundation. Because antidepressants help a great many people, “it would be unwise for anyone taking them to stop based on the results of this study alone.”
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