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Cardiovascular death and manic-depressive psychosis
1Institute of Psychiatric Demography, Aarhus Psychiatric Hospital, Risskov, Denmark.
Journal of Affective Disorders
|November 1, 1987
Summary
Tricyclic antidepressant drugs (TCA) do not increase cardiovascular death risk in manic-depressive patients. Findings suggest TCAs may even reduce risks of cardiovascular disease, suicide, and other non-cancer deaths.
Area of Science:
- Psychiatry
- Cardiology
- Pharmacology
Background:
- Manic-depressive illness (bipolar disorder) is associated with increased mortality.
- Tricyclic antidepressants (TCAs) are commonly prescribed for mood disorders.
- Concerns exist regarding the cardiovascular safety of TCAs.
Purpose of the Study:
- To investigate whether therapeutic doses of TCAs increase cardiovascular mortality risk in manic-depressive patients.
- To compare cardiovascular mortality rates before and during the widespread use of TCAs.
Main Methods:
- Retrospective cohort study using the Danish Psychiatric Central Register.
- Inclusion of two groups of first-hospitalized manic-depressive men: pre-TCA era (1950-1956) and TCA era (1969-1976).
- Follow-up period of approximately 4.5 years for both groups.
Main Results:
- Relative cardiovascular mortality was 1.87 in the pre-TCA group (n=1133) and 1.53 in the TCA era group (n=2662) compared to the general population.
- The observed rates do not support the hypothesis that TCAs increase cardiovascular mortality.
- A potential reduction in cardiovascular disease, suicide, and other non-cancer deaths was suggested with TCA treatment.
Conclusions:
- Tricyclic antidepressants (TCAs) do not appear to elevate cardiovascular mortality risk in individuals with manic-depressive illness.
- TCA treatment may be associated with a reduced risk of death from cardiovascular causes, suicide, and other non-cancerous conditions.
- Further research is warranted to confirm the potential protective effects of TCAs.