Use of Selective Serotonin Reuptake Inhibitors and Myocardial Infarction

In a recent study, Sauer et al 1 showed that the use of selective serotonin reuptake inhibitor antidepressants (SSRIs) may confer a protective effect against myocardial infarction (MI) in smokers. They hypothesized that this beneficial effect of SSRIs in reducing the risk of MI could mainly be attributed to the inhibitory effect on serotonin-mediated platelet activation in addition to treatment of depression itself. In contrast to these results, in a recent larger population-based case-control study, Meier et al 2 found that SSRI exposure adjusted for age, sex, geography, calendar time, smoking status, and body mass index was not associated with altered risk of developing first-time MI. MI risk estimates were also not influenced by timing, duration, and dosing of SSRIs. In addition, this analysis yielded no difference between patients using SSRIs or non-SSRIs, including tricyclic antidepressants (TCAs), with regard to MI. The reason for the discrepancy between results of the two aforementioned studies 1,2 is not clear.