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. 2011 Aug 2;343:d4551. doi: 10.1136/bmj.d4551

Table 4.

 Hazard ratios for five adverse outcomes (upper gastrointestinal bleeding, epilepsy/seizures, road traffic accidents, adverse drug reactions, and hyponatraemia) by antidepressant class, unadjusted and adjusted for confounders

Antidepressant class No of events* Hazard ratio (95% CI)
Unadjusted Adjusted†
Upper gastrointestinal bleeding
Not taking antidepressants 671 1.00 1.00
Tricyclic antidepressants 229 1.21 (1.04 to 1.41) 1.29 (1.10 to 1.51)
Selective serotonin reuptake inhibitors 365 1.27 (1.11 to 1.44) 1.22 (1.07 to 1.40)
Other antidepressants 79 1.36 (1.08 to 1.72) 1.37 (1.08 to 1.74)
Total events/total patients 1344/59 389
Epilepsy/seizures
Not taking antidepressants 223 1.00 1.00
Tricyclic antidepressants 58 0.99 (0.74 to 1.32) 1.02 (0.76 to 1.38)
Selective serotonin reuptake inhibitors 177 1.98 (1.62 to 2.43) 1.83 (1.49 to 2.26)
Other antidepressants 39 2.32 (1.67 to 3.24) 2.24 (1.60 to 3.15)
Total events/total patients in analysis 497/59 691
Road traffic accidents
Not taking antidepressants 252 1.00 1.00
Tricyclic antidepressants 56 0.83 (0.62 to 1.11) 0.86 (0.64 to 1.15)
Selective serotonin reuptake inhibitors 96 0.92 (0.72 to 1.16) 0.89 (0.70 to 1.13)
Other antidepressants 15 0.71 (0.42 to 1.19) 0.67 (0.39 to 1.14)
Total events/total patients 419/59 678
Adverse drug reactions
Not taking antidepressants 417 1.00 1.00
Tricyclic antidepressants 139 1.09 (0.89 to 1.32) 1.06 (0.86 to 1.29)
Selective serotonin reuptake inhibitors 231 1.20 (1.02 to 1.42) 1.16 (0.98 to 1.37)
Other antidepressants 37 1.00 (0.71 to 1.40) 0.95 (0.68 to 1.34)
Total events/total patients 824/60 170
Hyponatraemia
Not taking antidepressants 503 1.00 1.00
Tricyclic antidepressants 155 0.99 (0.82 to 1.18) 1.05 (0.87 to 1.27)
Selective serotonin reuptake inhibitors 383 1.62 (1.42 to 1.86) 1.52 (1.33 to 1.75)
Other antidepressants 62 1.38 (1.06 to 1.80) 1.28 (0.98 to 1.67)
Total events/total patients 1103/60 300

*Based on numbers included in unadjusted analyses.

†Adjusted for sex, age (five year bands), year, severity of depression, depression before age 65, smoking status, Townsend deprivation score, coronary heart disease, stroke/transient ischaemic attack, diabetes, hypertension, cancer, dementia, Parkinson’s disease, hypothyroidism, obsessive-compulsive disorder, statins, non-steroidal anti-inflammatory drugs, antipsychotics, lithium, aspirin, antihypertensive drugs, anticonvulsant drugs, hypnotics/anxiolytics; all outcomes except epilepsy/seizures also adjusted for epilepsy/seizures at baseline.