Depression, Antidepressant Use, and Risk of Venous Thromboembolism: Systematic Review and Meta-Analysis Of Published Observational Evidence

Kunutsor SK Seidu S, Khunti K. Ann Med. 2018 Jul 12:1-17. [CrossRef] [PubMed]

The authors conducted a systematic review and meta-analysis of published observational studies evaluating the associations of depression and antidepressant use with venous thromboembolism (VTE) risk. Eight observational studies with data on 960,113 non-overlapping participants and 9027 VTE cases were included. The pooled RR (95% CI) for VTE comparing antidepressant use with no antidepressant use was 1.27 (1.06-1.51). Tricyclic antidepressants, selective serotonin reuptake inhibitors and other antidepressants were each associated with an increased VTE risk; 1.16 (1.06-1.27), 1.12 (1.02-1.23), and 1.59 (1.21-2.09) respectively. In pooled analysis of three studies that compared patients with depression versus individuals without depression, the RR for VTE was 1.31 (1.13-1.53). The authors conclude that pooled observational evidence suggests that depression and use of antidepressants are each associated with an increased VTE risk. The effect of antidepressant drugs on VTE may be a class effect. The mechanistic pathways underlying these associations deserve further evaluation.