Antidepressants, Depression, and Venous Thromboembolism Risk: Large Prospective Study of UK Women

J Am Heart Assoc. 2017 May 17;6(5):e005316. doi: 10.1161/JAHA.116.005316.


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.

Keywords: antidepressants; cohort study; deep vein thrombosis; depression; pulmonary embolism.

MeSH terms

  • Aged
  • Antidepressive Agents / adverse effects*
  • Depression / diagnosis
  • Depression / drug therapy*
  • Depression / epidemiology
  • Depression / psychology
  • Humans
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Pulmonary Embolism / chemically induced*
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / epidemiology
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • United Kingdom / epidemiology
  • Venous Thromboembolism / chemically induced*
  • Venous Thromboembolism / diagnosis
  • Venous Thromboembolism / epidemiology
  • Venous Thrombosis / chemically induced*
  • Venous Thrombosis / diagnosis
  • Venous Thrombosis / epidemiology
  • Women's Health*


  • Antidepressive Agents