Depression, antidepressants and low hemoglobin level in the Paris Prospective Study III: A cross-sectional analysis

Prev Med. 2020 Jun:135:106050. doi: 10.1016/j.ypmed.2020.106050. Epub 2020 Mar 8.


Anemia is known to be associated with depression both in community and clinical populations. However, it is still unknown if this association depends or not on antidepressant intake. We investigated the respective association of depression and antidepressant intake with low hemoglobin level in a large community-based cohort. In 8640 volunteers aged 50 to 75 recruited between June 2008 and June 2012 in Paris (France), we assessed hemoglobin levels (g/dl), depressive symptoms and antidepressant intake. We examined the association of both depression and antidepressant intake with hemoglobin level, adjusting for numerous socio-demographic and health variables. We also assessed the association with specific antidepressant classes. Depression and antidepressant intake were independently associated with lower hemoglobin level (β = -0.074; p = .05 and β = -0.100; p = .02 respectively in the fully-adjusted model). Regarding antidepressant classes, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) intake were associated with lower hemoglobin level (β = -0.11; p = .01). To conclude, both depression and antidepressant intake were associated with lower hemoglobin level. In particular, as SSRI or SNRIs intake was also related to lower hemoglobin level, these classes should be used with caution in depressed individuals at risk for anemia.

Keywords: Antidepressant; Cohort study; Depression; Epidemiology; Hemoglobin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anemia / complications
  • Antidepressive Agents / classification
  • Antidepressive Agents / therapeutic use*
  • Cross-Sectional Studies
  • Depression / drug therapy*
  • Female
  • France
  • Hemoglobins / deficiency*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*


  • Antidepressive Agents
  • Hemoglobins
  • Serotonin Uptake Inhibitors