A new study presented at the European Society of Cardiology's EHRA 2025 congress has revealed a concerning association between the use of antidepressants and an increased risk of sudden cardiac death, particularly for individuals who have been on these medications for extended periods.
Sudden cardiac death is defined as an unexpected fatality caused by heart-related issues, typically occurring within an hour of symptom onset or within 24 hours in cases that are unwitnessed.
For individuals under 39, the primary causes are often related to thickening of the heart muscle or electrical abnormalities, whereas in older individuals, it is more frequently linked to narrowed blood vessels.
Previous research has indicated that individuals with psychiatric disorders face higher risks of both overall mortality and sudden cardiac death. However, the specific impact of antidepressant medications on sudden cardiac death risk has remained unclear until now.
The latest study, conducted by researchers in Denmark, analyzed deaths among residents aged 18 to 90 years in 2010, reviewing death certificates and autopsy reports to determine the connection between antidepressant use and sudden cardiac death.
The findings indicated that individuals using antidepressant medications had a significantly higher incidence of sudden cardiac death compared to those who were not taking these drugs.
The study compared a cohort of 643,999 individuals who had been prescribed antidepressants with the general population of 4.3 million residents. Among those exposed to antidepressants, 1,981 cases of sudden cardiac death were recorded, in contrast to 4,021 cases in the unexposed group.
The data showed that the risk of sudden cardiac death was higher across all age groups for those using antidepressants, with the risk increasing based on the length of exposure to the medication.
After adjusting for age, sex, and comorbidities, the researchers found that individuals who had been on antidepressants for one to five years had a 56 per cent higher risk of sudden cardiac death compared to the general population. Those who had used these medications for six or more years faced a 2.2 times greater risk.
The study further highlighted that younger individuals were particularly affected by prolonged antidepressant use. For those aged 30 to 39 years, the risk of sudden cardiac death was nearly three times higher with one to five years of antidepressant exposure, and up to five times higher for those who had been taking antidepressants for six or more years.
In older individuals, particularly those aged 50 to 59 years, the risk of sudden cardiac death doubled with one to five years of antidepressant use and increased fourfold with six or more years of exposure.
However, in individuals over the age of 70, the risk appeared to stabilise, with a less significant difference between shorter and longer exposure durations.
Dr. Jasmin Mujkanovic, a co-author of the study from Rigshospitalet Hjertecentret in Copenhagen, explained that the duration of antidepressant use was directly associated with an increased risk of sudden cardiac death, with those exposed for six or more years at even higher risk than those who had been on the medication for a shorter period.
She suggested that the elevated risk could stem from the potential adverse effects of antidepressants but also noted that prolonged exposure might indicate more severe underlying illness. Additionally, behavioral and lifestyle factors associated with depression, such as delayed healthcare-seeking behaviors and poor cardiovascular health, could further contribute to the increased risk.
This research underscores the need for further studies to better understand the cardiovascular risks associated with long-term antidepressant use.
Given the significantly higher risks of sudden cardiac death for individuals on these medications for extended periods, the findings highlight the importance of close monitoring and careful management of patients who require long-term antidepressant treatment.
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