ICU Risks Associated with Medications

Antidepressant use linked to higher risk of death in ICU for critically ill patients

May 27, 2012 / Author:  / Reviewed by: Joseph V. Madia, MD

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(dailyRx News) Mental health medications have come a long way over the past several decades. Yet doctors are still learning the effects of the newest drugs on the market and their links to conditions.

A recent study has found that critically ill patients who are taking common antidepressants are more likely to die in the hospital after being admitted to ICU than people not taking antidepressants.

"Depression is treatable - talk to your doctor if you're feeling depressed."

Lead author Katherine Berg, MD, and colleagues looked at the patient records of 10,568 people admitted to the ICU since 2001 at Beth Israel Deaconess Medical Center in Boston.

A total of 1,876 of these patients were taking either a selective serotonin reuptake inhibitor (SSRI) or a serotonin and norepinephrine reuptake inhibitor (SNRI) before they went to the ICU. These are two of the most common classes of antidepressant drugs.

The researchers compared the outcomes of these patients to patients admitted to ICU who were not taking antidepressants. They adjusted their calculations to control for the patients' age, gender, disease severity, diagnosis and any other conditions the patients might have had.

The patients taking SSRIs or SNRIs before arriving at the ICU were 73 percent more likely to die in the hospital than the patients who weren't taking antidepressants and were admitted to ICU.

The risk continued for a full year following admission to the ICU, though the increased risk of death did change according to what certain people's diagnoses were.

The patients who had acute coronary syndrome or had undergone cardiac surgery were most at risk for dying at the hospital, and their risk grew to more than twice as much if they were taking antidepressants.

Patients who arrived at the ICU because of a severe infection, however, were no more or less likely to die regardless of whether they were taking antidepressants.

The authors note that SSRIs and SNRIs, though carrying far fewer side effects than previous antidepressant drugs, have been linked to dizziness, falls, stroke and risk of bleeding in recent research.

They also point out, however, that their study does not show that taking antidepressants causes a person to die in the ICU or otherwise.

There is simply a link between taking these drugs and dying in the ICU, but it could be related to the reasons the people are taking the drugs, such as depression, anxiety or another mental disorder.

It could also be related to whether the people taking the antidepressants had other conditions not controlled for in the study, such as being smokers.

The study was presented May 22 at the American Thoracic Society's 2012 International Conference in San Francisco. Because it is unpublished, other scientists have not reviewed it for journal inclusion, and the data is still being analyzed, so it may change before possible publication.

The study's funding was not reported, and information regarding conflicts of interest was unavailable.
 

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Review Date: 
May 25, 2012
Last Updated:
August 15, 2012