Combining SSRIs, Antipsychotics Is Associated With Cardiotoxicity

Background: Selective serotonin reuptake inhibitors (SSRIs) and antipsychotic drugs are known to have at least some degree of potential cardiac toxicity including ventricular arrhythmias and sudden death. In recent years, concomitant prescription of the 2 drug classes has become much more common, particularly for bipolar illness and treatment-resistant depression or major depression with psychotic features. It is not known if there is an increased risk of cardiac toxicity when these 2 drug classes are combined. Objective: To evaluate the risks of drug-related cardiac disease among patients taking both SSRI and antipsychotic drugs. Design: Cohort study using a sequential target trial emulation method. Methods: Insurance claims in both the United States and Taiwan were studied. Eligible patients were entered based on taking antipsychotic drugs without SSRI. These were studied each week for 52 weeks for addition of any SSRI. Weekly trials were emulated to determine cardiovascular risks more...