Skip to main content

Table 2 Unadjusted and adjusted hazard ratios for six adverse outcomes (falls, fracture, upper gastrointestinal bleed, road traffic accident, adverse drug reaction, and all-cause mortality) by antidepressant class compared with periods of non-use of antidepressants over 5 years follow-up

From: Antidepressant use and risk of adverse outcomes in people aged 20–64 years: cohort study using a primary care database

   

Unadjusted analysis

Adjusted analysisb

Antidepressant class

No of eventsa

Person-yearsa

Hazard ratio

95% CI

Hazard ratio

95% CI

P

Falls

 No current use

2493

558,933

1.00

 

1.00

  

 TCAs

298

40,260

1.79

(1.58–2.04)

1.36

(1.19–1.54)

< 0.001

 SSRIs

1494

221,813

1.62

(1.52–1.73)

1.48

(1.39–1.59)

< 0.001

 Other antidepressants

189

27,678

1.64

(1.42–1.89)

1.43

(1.23–1.66)

< 0.001

 Combined antidepressants

37

4121

2.03

(1.48–2.78)

1.61

(1.16–2.22)

0.004

Fracture

 No current use

2759

510,172

1.00

 

1.00

  

 TCAs

205

37,309

1.04

(0.90–1.20)

0.92

(0.80–1.06)

0.26

 SSRIs

1466

204,592

1.35

(1.26–1.44)

1.30

(1.21–1.39)

< 0.001

 Other antidepressants

195

25,164

1.43

(1.24–1.65)

1.28

(1.11–1.48)

0.001

 Combined antidepressants

29

3759

1.39

(0.94–2.06)

1.22

(0.82–1.81)

0.32

Upper GI bleed

 No current use

588

570,654

1.00

 

1.00

  

 TCAs

79

41,295

1.83

(1.45–2.29)

1.43

(1.13–1.81)

0.003

 SSRIs

300

226,336

1.21

(1.05–1.39)

1.16

(1.00–1.33)

0.045

 Other antidepressants

50

28,102

1.74

(1.31–2.31)

1.35

(1.00–1.82)

0.050

 Combined antidepressants

12

4245

2.65

(1.49–4.69)

2.13

(1.19–3.79)

0.010

Road traffic accident

 No current use

2343

546,915

1.00

 

1.00

  

 TCAs

154

39,929

0.87

(0.72–1.05)

0.97

(0.80–1.17)

0.72

 SSRIs

929

218,137

0.97

(0.89–1.05)

1.03

(0.95–1.12)

0.47

 Other antidepressants

120

27,221

1.01

(0.84–1.22)

1.08

(0.90–1.30)

0.41

 Combined antidepressants

18

4063

1.00

(0.64–1.56)

1.12

(0.71–1.76)

0.62

Adverse drug reaction

 No current use

432

571,401

1.00

 

1.00

  

 TCAs

122

41,380

3.11

(2.50–3.87)

2.69

(2.15–3.37)

< 0.001

 SSRIs

396

226,577

1.88

(1.62–2.19)

1.75

(1.50–2.04)

< 0.001

 Other antidepressants

70

28,197

3.03

(2.29–4.01)

2.81

(2.11–3.75)

< 0.001

 Combined antidepressants

11

4257

3.29

(1.81–5.97)

2.92

(1.60–5.35)

0.001

All-cause mortality

 No current use

1541

575,623

1.00

 

1.00

  

 TCAs

326

41,807

2.89

(2.54–3.29)

1.92

(1.68–2.19)

< 0.001

 SSRIs

990

228,233

1.63

(1.50–1.78)

1.38

(1.26–1.51)

< 0.001

 Other antidepressants

196

28,487

2.61

(2.24–3.03)

1.74

(1.48–2.06)

< 0.001

 Combined antidepressants

41

4299

3.62

(2.69–4.88)

2.19

(1.60–3.00)

< 0.001

  1. aBased on numbers in adjusted analysis (patients with missing values for confounding variables were excluded from the adjusted analyses – during 5 years follow-up, 141 of these patients had falls, 142 had fractures, 37 had upper gastrointestinal bleeds, 126 had road traffic accidents, 27 had adverse drug reactions and 87 died)
  2. bAdjusted for age, sex, year of diagnosis of depression, severity of depression, deprivation, smoking status, alcohol intake, ethnic group (white/not recorded or non-white), coronary heart disease, diabetes, hypertension, cancer, epilepsy/seizures, hypothyroidism, osteoarthritis, asthma/chronic obstructive airways disease, stroke/TIA, rheumatoid arthritis, osteoporosis, liver disease, renal disease, obsessive-compulsive disorder, statins, NSAIDS, aspirin, antihypertensive drugs, anticonvulsants, hypnotics/anxiolytics, oral contraceptives, hormone replacement therapy, antipsychotics, bisphosphonates, anticoagulants; fracture outcome also adjusted for falls
  3. GI gastrointestinal, SSRIs selective serotonin reuptake inhibitors, TCAs tricyclic and related antidepressants
Back to article page

BMC Medicine

ISSN: 1741-7015

Contact us