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This study aimed to examine possible associations between the use of angiotensin II receptor blockers (ARBs), angiotensin\u2010converting enzyme inhibitors (ACEI), acetylsalicylic acid (ASA), beta\u2010blockers (BB), calcium channel blockers (CCB), diuretics, or metformin and risk of antidepressant initiation. The Tr\u00f8ndelag Health Study (HUNT3), Norway, was linked to the Norwegian Prescription Database (NorPD). Participants with no prescriptions of cardiovascular agents, metformin, or antidepressants for at least 6\u2009months before HUNT3 (baseline) were eligible and followed for 10\u2009years. The exposure was the use of cardiovascular agents or metformin, defined as mono\u2010 or polytherapy from baseline to end of follow\u2010up. The outcome was the initiation of antidepressant use, indicated by the first drug dispensation during the study period and expressed as hazard ratios (HRs) with 95% confidence intervals (CI). Among 20\u2009227 adults aged 40\u201370\u2009years at baseline, we observed different associations between cardiovascular agents or metformin and the risk of antidepressant initiation. ARBs or CCB monotherapy was associated with a lower risk of initiating antidepressant use (HR 0.70; 95%CI 0.56\u20130.88 and HR 0.81; 95%CI 0.61\u20131.06, respectively) compared to no use of any drugs included in the study (reference). Reduced risk of antidepressant initiation was among ASA or statin polytherapy users, whereas there was a small increased risk among participants on ASA monotherapy. In contrast, there was no statistical evidence of associations between ACEI, BB, diuretics, or metformin and increased or decreased risk of antidepressant initiation. Our mixed findings indicate the possibility that some cardiovascular agents may be associated with a reduced risk of initiating antidepressant use while others may not. However, bias due to the limitations of the study design is possible.<\/jats:p>","DOI":"10.1002\/prp2.1078","type":"journal-article","created":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T06:56:32Z","timestamp":1680677792000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk of antidepressant initiation among users of cardiovascular agents and metformin."],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2609-7536","authenticated-orcid":false,"given":"Ivana","family":"Bojani\u0107","sequence":"first","affiliation":[{"name":"Faculty of Nursing and Health Sciences Nord University  Levanger Norway"},{"name":"Department of Public Health and Nursing, Faculty of Medicine and Health Sciences Norwegian University of Science and Technology, NTNU  Trondheim 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