Evidence continues to mount that even supposedly "safer" antidepressants increase women's risk of stroke and death.
One of the reasons that doctors prefer selective serotonin reuptake inhibitor (SSRI) antidepressants to the older tricyclics is that the latter are known to have negative effects on heart function (and depression itself is already a risk factor for cardiovascular disease). Over the past five years, evidence has started to emerge that SSRIs may also increase cardiovascular risk, particularly among older women.
More strokes, deaths among women
Because older women are also at increased risk of cardiovascular disease, a study published in the Archives of Internal Medicine in December 2009 examined whether SSRIs increased this risk among women participating in the Women's Health Initiative (WHI) study.
The research was conducted by a team of scientists from Massachusetts General Hospital, the University of California, San Diego, the University of Washington, the University of Hawaii, the University of Iowa, the University of Massachusetts Medical Center and Emory University.
The landmark WHI study tracked more than 160,000 postmenopausal women for as much as 15 years, collecting data on disease, mortality and lifestyle factors that might affect cardiovascular disease, cancer or osteoporosis.
The 2009 analysis focused on the 136,000 participants who were not taking any antidepressant at the study's start. By three years into the study, 5,500 of the participants were taking an antidepressant; these women were compared with participants who never started taking antidepressants.
The researchers found that, after an average six-year followup, women who took SSRIs were significantly more likely to suffer a hemorrhagic stroke or die from any cause than women not taking antidepressants.
The study did not find any relationship between SSRIs and heart disease, and the overall risk of stroke and death was still small even among women taking antidepressants. Nevertheless, doctors need to be made aware of the risk, the researchers said.
"Older women taking antidepressants can talk with their physicians about their cardiovascular risk, work on modifying other risk factors, and discuss the risks and benefits of various treatment options," lead author Jordan W. Smoller said.
One of the reasons that doctors prefer selective serotonin reuptake inhibitor (SSRI) antidepressants to the older tricyclics is that the latter are known to have negative effects on heart function (and depression itself is already a risk factor for cardiovascular disease). Over the past five years, evidence has started to emerge that SSRIs may also increase cardiovascular risk, particularly among older women.
More strokes, deaths among women
Because older women are also at increased risk of cardiovascular disease, a study published in the Archives of Internal Medicine in December 2009 examined whether SSRIs increased this risk among women participating in the Women's Health Initiative (WHI) study.
The research was conducted by a team of scientists from Massachusetts General Hospital, the University of California, San Diego, the University of Washington, the University of Hawaii, the University of Iowa, the University of Massachusetts Medical Center and Emory University.
The landmark WHI study tracked more than 160,000 postmenopausal women for as much as 15 years, collecting data on disease, mortality and lifestyle factors that might affect cardiovascular disease, cancer or osteoporosis.
The 2009 analysis focused on the 136,000 participants who were not taking any antidepressant at the study's start. By three years into the study, 5,500 of the participants were taking an antidepressant; these women were compared with participants who never started taking antidepressants.
The researchers found that, after an average six-year followup, women who took SSRIs were significantly more likely to suffer a hemorrhagic stroke or die from any cause than women not taking antidepressants.
The study did not find any relationship between SSRIs and heart disease, and the overall risk of stroke and death was still small even among women taking antidepressants. Nevertheless, doctors need to be made aware of the risk, the researchers said.
"Older women taking antidepressants can talk with their physicians about their cardiovascular risk, work on modifying other risk factors, and discuss the risks and benefits of various treatment options," lead author Jordan W. Smoller said.
"There are other effective forms of therapy for patients at high cardiovascular risk who also have depression, so concerned women can explore these options with their physicians."
Bad for your heart too?
These findings were strengthened by a meta-analysis published in the journal Neurology in 2012. Researchers reviewed all the studies they could find that examined the connection between antidepressants and stroke, which came to 16 studies including more than 500,000 participants. The researchers found that people taking SSRIs had a 50 percent higher risk of intracranial hemorrhage and a 40 percent higher risk of intracerebral hemorrhage compared with those not taking SSRIs.
This might suggest that patients with other risk factors for bleeding-induced strokes (such as those taking blood thinners, abusing alcohol or with a history of such strokes) should not be given SSRIs, the researchers said.
In June 2013, another analysis of WHI data was published in the American Journal of Public Health. This analysis found that postmenopausal women taking antidepressants were significantly more likely to have a larger waist circumference, a higher body mass index and higher levels of the inflammation marker known as C-reactive protein (CRP). These are all major risk factors for cardiovascular disease and diabetes.
"Given that diabetes and cardiovascular disease can be effectively prevented or delayed in high-risk individuals... our findings indicate the prudence of monitoring BMI, waist circumference, along with established biomarkers for diabetes and cardiovascular risk... among women with elevated depression symptoms, or who are taking antidepressant medication," researcher Dr. Simin Liu said.
Sources for this article include:
http://www.massgeneral.org
http://www.sciencedaily.com
http://www.sciencedaily.com
http://science.naturalnews.com
http://www.naturalnews.com/044775_antidepressants_cardiovascular_risk_depression.html#ixzz2zHCZDCcl
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