Antidepressants,depression,and venous thromboembolism risk: Large prospective study of UK women

Background- some investigators have reported an excess risk of venous thromboembolism (vte) associated with depression and with use of antidepressant drugs. we explored these associations in a large prospective study of uk women. methods and results- the million women study recruited 1.3 million women through the national health service breast screening programme in england and scotland. three years after recruitment,women were sent a second questionnaire that enquired about depression and regular use of medications in the previous 4 weeks. the present analysis included those who responded and did not have prior vte,cancer,or recent surgery. follow-up for vte was through linkage to routinely collected national health service statistics. cox regression analyses yielded adjusted hazard ratios and 95% cis. a total of 734 092 women (mean age 59.9 years) were included in the analysis; 6.9% reported use of antidepressants,2.7% reported use of other psychotropic drugs,and 1.8% reported being treated for depression or anxiety but not use of psychotropic drugs. during follow-up for an average of 7.3 years,3922 women were hospitalized for and/or died from vte. women who reported antidepressant use had a significantly higher risk of vte than women who reported neither depression nor use of psychotropic drugs (hazard ratio,1.39; 95% ci,1.23-1.56). vte risk was not significantly increased in women who reported being treated for depression or anxiety but no use of antidepressants or other psychotropic drugs (hazard ratio,1.19; 95% ci,0.95-1.49). conclusions- use of antidepressants is common in uk women and is associated with an increased risk of vte. © 2017 the authors.