Arrhythmias & electrophysiology

Antidepressant treatment duration and risk of sudden cardiac death: A nationwide cohort study

Heart RhythmPublished nationwide cohort study

Authors' conclusion

Long-term AD treatment was associated with increased SCD risk in a duration- and recency-dependent manner across major drug classes. Although causality cannot be inferred, these findings identify patients receiving prolonged AD therapy as a population at elevated cardiovascular risk, warranting further investigation.

Study context

Population
Danish residents aged 18–90 years during 2010Danish residents, 6002 sudden cardiac death (SCDs)
Participants
4.3 million residents
Exposure
AD use categorized by cumulative duration and recency
Outcome
SCDs occurring in AD users

Main finding

As reported in the abstract

SCDs in AD users, among 6002 SCDs

1907

32%

Observational data: associations, not effects.

Further findings

SCD by cumulative duration of AD use

Adjusted HR (95% CI)
1-5 years1.41 (1.31–1.51)
≥6 years1.74 (1.59–1.90)

SCD by recency of AD use

HR (95% CI)
Current users1.71 (1.59–1.83)
Recent1.24 (1.09–1.42)
Remote users1.11 (0.97–1.27)

SCD by drug class and duration

HR (95% CI)
Selective serotonin reuptake inhibitors, 1-5 years1.38 (1.28–1.49)
Selective serotonin reuptake inhibitors, ≥6 years1.57 (1.42–1.75)
Tricyclic ADs, 1-5 years1.24 (1.09–1.42)
Tricyclic ADs, ≥6 years1.40 (1.15–1.71)

SCD by recency of AD use

A temporal gradient emerged: current users showed the highest risk

SCD by drug class and duration

Associations were consistent across drug classes

Original publication

Antidepressant treatment duration and risk of sudden cardiac death: A nationwide cohort study. Heart Rhythm. Published 12 March 2026. doi:10.1016/j.hrthm.2026.03.006

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