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Antidepressant adverse events cohort

In 238,963 adults aged 20–64 with depression, most used antidepressants and several common agents associated with higher fall rates versus non-use.

Source

Antidepressant use and risk of adverse outcomes in people aged 20-64 years: cohort study using a primary care database

Coupland C, Hill T, Morriss R, et al. · BMC medicine · 2018

doi.org/10.1186/s12916-018-1022-xRead the full paper ↗67 citationscc by

What they did

UK primary-care database cohort followed eligible newly diagnosed depression patients for adverse outcomes across antidepressant classes and individual drugs.

What they found

87.7% received antidepressants; citalopram, fluoxetine, and amitriptyline were most prescribed; 8 of 11 common drugs linked to significantly higher falls vs non-use over 5 years.

The limits

What it doesn't show

Observational signals can reflect confounding by indication; absolute risks and benefits still need joint clinical judgment.

Key terms

SSRI
Selective serotonin reuptake inhibitor antidepressant class.
Confounding by indication
Sicker patients preferentially receive certain drugs, biasing associations.
Primary-care database
Electronic health records used to build the cohort.
Falls
Adverse outcome elevated for several antidepressants vs non-use.
aHR
Adjusted hazard ratio comparing treatment groups.
Working-age adults
Cohort aged 20–64 years at depression diagnosis.

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Final N?

Common questions

Final cohort size?

238,963 eligible patients.

Treated proportion?

87.7% received antidepressants in follow-up.

Top drugs?

Citalopram, fluoxetine, amitriptyline.

Falls finding?

8/11 common antidepressants associated with higher fall rates vs non-use.

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