Association Between Antidepressant Use and Risk of Venous Thromboembolism: A Systematic Review and Meta-Analysis

TL;DR

This study finds that using antidepressants is linked to a slightly higher risk of blood clots in veins, especially for recent users and those with specific types of clotting events.

Contribution

The study provides a comprehensive meta-analysis of observational data to quantify the VTE risk associated with antidepressant use.

Findings

Antidepressant use is associated with a 22% increased risk of venous thromboembolism.

Recent antidepressant use (within 90 days) shows a stronger association with VTE.

The risk is elevated for both first-time and recurrent VTE events, as well as pulmonary embolism.

Abstract

Objectives: To evaluate the association between antidepressant use and the risk of venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism (PE), through a systematic review and meta-analysis of observational studies. Methods: A comprehensive literature search was conducted in Medline, Embase®, and Web of Science® up to December 2024. Eighteen studies (cohort, case-control, and nested case-control designs) meeting inclusion criteria were analyzed. Study quality was assessed using the Newcastle–Ottawa Scale. Pooled relative risks (RR) with 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analyses were performed based on recency of antidepressant use, VTE onset type (first vs. recurrent), and VTE subtype (PE). Results: Antidepressant use was associated with a significantly increased risk of VTE (RR = 1.22; 95% CI: 1.12–1.32; p < 0.001). Subgroup analyses revealed a stronger association for recent use (within 90 days), first-onset VTE, recurrent VTE, and PE. Heterogeneity was high (I2 = 87.92%), but sensitivity analysis confirmed result robustness. No publication bias was detected. Conclusions: This meta-analysis indicates a modest but statistically significant increase in the risk of VTE associated with antidepressant use, particularly among recent users, individuals experiencing either first-time or recurrent VTE, and those with PE-type events. These findings highlight the importance of individualized VTE risk assessment when initiating antidepressant therapy.

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