Key result
Antidepressant toxicity, especially from TCAs, is linked to severe cardiotoxicity requiring advanced multidisciplinary support.
Why the study?
Antidepressants are fundamental for treating depression, but their use can be associated with adverse effects, including cardiotoxicity.
Systematic Review (n=20)
This systematic review of case reports reinforces that antidepressant use, particularly TCAs, can cause severe systemic cardiotoxicity including life-threatening arrhythmias and cardiogenic shock, which may necessitate advanced interventions like ECMO and sodium bicarbonate.
Clinicians should anticipate severe antidepressant cardiotoxicity, especially with TCAs, and prepare for advanced interventions; extends case-report evidence but leaves open prospective validation.
Background: Depression is one of the leading causes of disability worldwide, with a significant impact on individuals’ quality of life. The use of antidepressants is fundamental in the treatment of this condition; however, it is essential to recognize that the use of these drugs can be associated with adverse effects, including cardiotoxicity. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was conducted of the PubMed/Medline, Scopus, and Cochrane databases. Twenty studies were included in the final quantitative analysis. The Joanna Briggs Institute critical appraisal tool was used to assess the risk of bias. Results: It is possible to highlight a correlation between intake of antidepressants and development of cardiotoxicity. Analysis of the selected studies allows for an understanding of the importance of a multidisciplinary approach for the protection of these patients. Conclusions: Management of antidepressant-induced cardiotoxicity requires a thorough understanding of the pathophysiological mechanisms involved and a critical evaluation of the various therapeutic strategies available to promote clinical practice.
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Nakhebi et al. (2025) conducted a systematic review in Antidepressant-induced cardiotoxicity in depressive disorders (n=20). Antidepressant use (TCAs, bupropion, SSRIs, SNRIs) was evaluated on Correlation between antidepressant intake and development of cardiotoxicity. The use of antidepressants, particularly TCAs, was associated with severe systemic cardiotoxicity requiring multidisciplinary management such as sodium bicarbonate, ECMO, or targeted temperature management.
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