How Risky Are Tricyclic Antidepressants?

Overdoses of tricyclic antidepressants (TCAs) are cardiotoxic, but scientists debate the cardiac risk at standard doses. These investigators used 5 years of Medicaid records from . . .

Overdoses of tricyclic antidepressants (TCAs) are cardiotoxic, but scientists debate the cardiac risk at standard doses. These investigators used 5 years of Medicaid records from a study of sudden cardiac death to determine the relative risk for death from cardiac arrest in nonhospitalized patients who have no histories of noncardiac conditions predisposing to sudden death.

Patients taking both TCAs and SSRIs were excluded. The data set comprised 1,120,625 person-years of nonuse of antidepressants, 58,956 person-years of current TCA use, 6291 person-years of current SSRI use, and 96,220 person-years of past antidepressant use (91,100 for past TCA users). A total of 1487 deaths were classified as possible or probable sudden cardiac deaths.

Cur…

Reviewing Author

Steven Dubovsky, MD