Grant: Project Grant

In Canada, antidepressant use is common, with about 20% of women and 10% of men receiving prescriptions. In 2022, this amounted to 44 million prescriptions for women and 22 million for men. Individuals with cardiovascular disease (CVD) are 3 to 5 times more likely to be diagnosed with anxiety and/or depression, with a bidirectional relationship between the conditions. The links between antidepressant and CVD remain uncertain, as studies have shown protective, neutral, or adverse effects. Our group previously found that women are at higher risk for arrhythmias, and that antidepressants is a risk factor. Sex-differences in drug metabolism, hormonal changes, and gender roles can further affect vulnerability to depression, drug exposure, and CV risk. Our primary goal is to determine how antidepressant affects CVD and mortality in patients with anxiety and/or depression, with specific attention to sex/gender differences. We will also investigate how drug-related factors - type of drug used, dose/duration, and concurrent medications-impact CVD and mortality. This study will use a real-world large primary care and hospital database, providing enough information on a wide range of patients to analyze data according to sex/gender. Our diverse research team has strong expertise in epidemiology, psychiatric medications, and advanced methods. Since Canada and the UK have similar economic, social parameters and prescribing patterns, our findings will be applicable to Canadians. By advancing understanding of sex/gender-specific CV risks and benefits of antidepressant use, our research will guide safer and more effective prescription practices. It will help improve health outcomes for Canadians living with anxiety and depression, and reduce the burden of CV disease on the patients and the healthcare system.