Depression treatment: antidepressants did not raise early serious heart events

If you take an antidepressant, or are thinking about starting one, here is good news. A large analysis of depression treatment found that antidepressants were not linked to more early serious heart events than placebo, a look-alike pill with no medicine in it.

The study also found that antidepressants differ in how they affect one heart rhythm measure. That gives you and your doctor something useful when choosing the right one for you.

How the study worked

Researchers pooled double-blind randomized trials of adults with major depression, using personal data from 8,679 people in 35 trials plus results from 139 trials for heart events, and published it Sept. 23, 2026 in The BMJ. Personal data were available for only part of the trials, and the follow-up covered the first eight weeks of treatment.

What they found

The headline result is about serious heart events and sudden deaths not related to suicide. Across 139 trials, people on antidepressants had no more of them than people on placebo. The difference was 0.01%, which is next to nothing.

The second result is about a heart rhythm measure called the QTc interval. The study looked at 10 antidepressants: amitriptyline, bupropion, duloxetine, escitalopram, fluoxetine, mirtazapine, paroxetine, trazodone, venlafaxine and vortioxetine.

Compared with placebo, escitalopram lengthened the QTc by 8.7 milliseconds and amitriptyline by 5.3 milliseconds. A millisecond is a thousandth of a second. When the researchers took personal factors into account, amitriptyline and escitalopram most often had the largest effect. Venlafaxine and vortioxetine often had the smallest.

Effects also varied from person to person, especially with escitalopram, fluoxetine and mirtazapine. The same medicine can behave differently in different bodies. The researchers looked at age, sex assigned at birth, body mass index, potassium level in the blood and kidney function.

What is the QTc, and why does it come up?

Your heart beats, then recharges for the next beat. An electrocardiogram, the heart tracing doctors call an ECG or EKG, shows how long that recharge takes. That time is the QT interval, and the QTc is the same number adjusted for your heart rate.

The QTc is something doctors can see and measure, so it helps them compare medicines. In this analysis, the early serious heart events were no more common on antidepressants. The QTc finding simply helps match the drug to the person.

What you can do today

You may be wondering which of these you take and what it means for you. The study shows these medicines are safe for the heart in the early weeks of treatment, and the differences are something to use, not to fear. Take a few minutes to get ready for your next visit.

Write down the name of your antidepressant and every other medicine you take, including over-the-counter ones. Add anything about your heart that your doctor should know, such as fainting spells, heart disease, or a relative who died suddenly. Then bring the list to your next appointment or to your pharmacist at CVS, Walgreens or your local pharmacy. Ask: “Is my medicine a good fit for me?” Keep taking your medicine as prescribed while you do.