Arrhythmias & electrophysiology
QTc changes and early major adverse cardiovascular events associated with antidepressant treatment for major depressive disorder in adults: individual participant data network meta-regression of double blind randomised trials
Authors' conclusion
The effect of specific antidepressants on QTc interval differed between adults with depression. No evidence associated antidepressant use with early MACE and non-suicidal sudden death.
Study context
- Population
- Adults (≥18 years) with major depressive disorder35 RCTs with individual participant data (IPD)
- Participants
- 8,679 adults
- Comparison
- Specific antidepressants vs placebo
- Outcome
- Change in QTc Fridericia (QTcF) with specific antidepressants and placebo, accounting for modifiable and non-modifiable risk factors
- Follow-up
- First eight weeks of treatment
Pooled result
As reported in the abstract
QTc change vs placebo
Each group vs placeboDifference, ms (95% CrI)
Escitalopram
8.7(1.6–15.8)
Amitriptyline
5.3(0.8–9.8)
- Highest QTc prolongations when risk factors considered: amitriptyline
- 58.8%
- Highest QTc prolongations when risk factors considered: escitalopram
- 21.3%
- Lowest QTc intervals: venlafaxine
- 24.1%
- Lowest QTc intervals: vortioxetine
- 9.7%
Safety
| Outcome | Risk difference (95% CrI) | |
|---|---|---|
| Early MACE and non-suicidal deathAntidepressantsvs Placebo139 trials, 52 398 participants; CrI · CrI | 0.01% (−0.01% to 0.02%) | |
| −0.02−0.0100.010.020.03Difference (linear scale) |
Early MACE and non-suicidal death
- No association between antidepressant use and increased early MACE and non-suicidal death
Original publication
QTc changes and early major adverse cardiovascular events associated with antidepressant treatment for major depressive disorder in adults: individual participant data network meta-regression of double blind randomised trials. BMJ. Published 23 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →