A small Zurich study: inpatients given antidepressants were rehospitalized more often than matched patients who were not
Forty five matched pairs, twelve months after discharge: 35.6 percent of antidepressant users were rehospitalized against 22.2 percent of non-users; two or more readmissions, 22.2 against 2.2 percent.
Suggestive but preliminary. Not settled. how we score evidence
Caveat on this rating: Very small matched sample from two hospitals; confounding by indication is the central objection. Mixed diagnoses. Not replicated in a large cohort.
This is the study most often cited for the claim that antidepressants make long-term outcomes worse. It deserves to be read for what it is.
Significant findings
Hengartner and colleagues (Frontiers in Psychiatry, 2019) took 151 inpatients "with a mixed range of diagnoses enrolled at two psychiatric hospitals in Zurich" and built "matched pairs of n = 45 antidepressant users and n = 45 non-users", matched on "14 clinically relevant covariates assessing psychosocial impairments, functioning deficits and illness severity."
"Altogether 35.6% of antidepressant users were rehospitalised at least once, as compared to 22.2% in matched non-users. Two or more rehospitalisations occurred in 22.2% of antidepressant users but only in 2.2% of non-users. In antidepressant users, the mean total duration of rehospitalisations was 22.22 days, as compared to 8.51 in matched non-users." The adjusted rate ratio for rehospitalization was 3.64 (95% CI 1.71 to 7.75).
The authors: "Our findings raise the possibility that, in the long-term, antidepressants may impair recovery and increase the risk of rehospitalisation". "More work is required".
Worth asking
Ninety people, two hospitals, one year, and no randomization. Doctors give antidepressants to the patients they are more worried about, and matching on fourteen measured things cannot capture what a clinician sees in a room. The authors say "raise the possibility", and that is the right strength. It has not been replicated at scale. It earns a place here because the question is legitimate and almost nobody has tested it, not because it answers it. Never stop an antidepressant on your own.
Source
Antidepressant Use During Acute Inpatient Care Is Associated With an Increased Risk of Psychiatric Rehospitalisation Over a 12-Month Follow-Up After Discharge — Hengartner MP, Passalacqua S, Andreae A, Heinsius T, Hepp U, Rossler W, von Wyl A (2019)
Indexed peer-reviewed journal
Read the source: https://doi.org/10.3389/fpsyt.2019.00079
DOI: 10.3389/fpsyt.2019.00079
How this was scored
- Study design
- Cohort study
- Funding
- Funding not disclosed
- Published in
- Indexed peer-reviewed journal
- Sample size
- 90
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published September 21, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "early signal". Suggestive but preliminary. Not settled. It scores 43 out of 100 on our published rubric. One caveat travels with that badge: Very small matched sample from two hospitals; confounding by indication is the central objection. Mixed diagnoses. Not replicated in a large cohort. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Antidepressant Use During Acute Inpatient Care Is Associated With an Increased Risk of Psychiatric Rehospitalisation Over a 12-Month Follow-Up After Discharge — Hengartner MP, Passalacqua S, Andreae A, Heinsius T, Hepp U, Rossler W, von Wyl A (2019). Published in: Indexed peer-reviewed journal. DOI: 10.3389/fpsyt.2019.00079. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Cohort study. Funding: Funding not disclosed. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.