No significant differences in 1-year all-cause mortality risks were seen among patients treated with antidepressants from a single class in the first 90 days, a study in the Journal of Clinical Psychopharmacology reported.

Past studies have evaluated whether depression is a mortality risk factor but not many have investigated whether antidepressant drugs impact mortality risk. Study authors estimated hazards of 1-year all-cause mortality associated with antidepressants in 720,821 patients, with use occurring within 90 days of a depression diagnosis. They accounted for potential clinical and demographic confounders; sensitivity analyses compared findings by antidepressant class. 

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Results showed that use of antidepressants was associated with significantly lower hazards of 1-year mortality risk vs. no use in Cox (hazard ratio [HR] 0.93, 95% CI: 0.90–0.97) and propensity score estimates (HR 0.94, 95% CI: 0.91–0.98). Marginal structural model-based estimates showed no differences in mortality risk when the exposure was specified as “as-treated” in every 90-day intervals of the 1-year follow-up (HR 0.91, 95% CI: 0.66–1.26) but showed a higher risk when “intent-to-treat” was specified (HR 1.07, 95% CI: 1.02–1.13).

Researchers found no significant differences in 1-year all-cause mortality risks with use in the first 90 days. Moreover, after accounting for treatment selection bias and various confounders, antidepressant use was associated with no excess harm.

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