Selective serotonin reuptake inhibitors and pulmonary arterial hypertension: a case-control study

Background — Animal and human studies suggest that selective serotonin reuptake inhibitors (SSRIs) might be useful for the prevention or treatment of pulmonary arterial hypertension.

Methods — The authors conducted a population-based, nested case-control study to explore the hypothesis that SSRIs might reduce the risk of pulmonary arterial hypertension. Cases were individuals who developed pulmonary arterial hypertension requiring pharmacological treatment. For each case, the researchers selected up to 10 matched controls. Exposure to SSRIs and non-SSRI antidepressants was ascertained using administrative data. The outcome of pulmonary arterial hypertension requiring pharmacologic therapy was defined as the receipt of a drug specific for the treatment of pulmonary arterial hypertension.

Results — In contrast to our hypothesis, and likely because of residual confounding, the researchers found a positive association between SSRI use and pulmonary arterial hypertension (adjusted odds ratio 1.55; 95% confidence interval 1.13-2.13).

Discussion — At conventional doses, SSRIs are not associated with a reduced risk of pulmonary arterial hypertension.