Results from a US study suggest that postmenopausal women who take antidepressants have an increased, but relatively small, risk of stroke and death.

An analysis published in the Archives of Internal Medicine is based on data taken from 136,293 females participating in a Women's Health Initiative Study. Cardiovascular morbidity and all-cause mortality for women with new antidepressant use at follow-up (5,496 participants) were compared with those characteristics for women not taking the drugs for a follow-up period of 5.9 years.

The results showed that patients taking selective serotonin reuptake inhibitors had a 45% increased risk of stroke and a 32% higher risk of death from all causes, compared to those who were not receiving antidepressants. However the analysis noted that there were no significant differences in risk of stroke, mortality or coronary heart disease for women taking SSRIs compared with those taking tricyclic antidepressants.

Researcher Sylvia Wassertheil-Smoller of Albert Einstein College of Medicine stressed that patients and doctors have to weigh the benefits from these antidepressants “against the small increase in risk that we found in this study." The absolute risk of stroke was just 0.43% a year for women taking antidepressants compared to 0.3% for those not on the drugs.

Lead investigator Jordan Smoller of the Massachusetts General Hospital, added that "although these results raise concerns about adverse effects of antidepressants, it is important to note that depression itself has been implicated as a risk factor for coronary heart disease, stroke, early death, and other adverse outcomes”. He also noted that inadequately treated depression is associated with s”ubstantial disability, impairments in quality of life and healthcare costs”.

Dr Smoller added that “nevertheless, our results suggest that physicians should be vigilant about controlling other modifiable cardiovascular risk factors in women taking antidepressants”. He concluded by saying that further research is needed “to clarify the risk-benefit ratio of antidepressant use among older women”.