By Sherry Baker
March 3, 2009
Feeling a little down, a little anxious? Odds are a trip to the doctor will land you a prescription for an antidepressant. And if you are worried about major side effects, you'll most likely be told, why, millions of folks take SSRI drugs like Prozac and they have a great safety profile. In fact, people who are depressed after a heart attack are often put on the drugs because, the reasoning goes, depression can hurt the heart so the drugs must help the heart.
Right? Turns out, the answer is dead wrong. In fact, antidepressants may be dangerous for people with no known heart problems, according to research just published in March issue of the Journal of the American College of Cardiology (ACC).
However, if you quickly just read the press release put out by the ACC (http://www.eurekalert.org/emb_releases/2009-03/acoc-fda030609.php), you might come away with the impression the study's conclusions were primarily about depression being linked to heart problems in women. And the study does show a solid connection between depression and sudden cardiac death (SCD) and fatal coronary heart disease (CHD) in women without any previously discovered heart problems. But what is downplayed in the press release spin is that the women with the highest risk for SCD and fatal CHD had the most depressive symptoms or were taking antidepressants.
Most importantly, according to the research headed by William Whang, M.D., M.S., Division of Cardiology, Columbia University Medical Center, the risk of cardiac death --including dropping dead suddenly -- was associated more strongly with being on antidepressant drugs than with experiencing symptoms of clinical depression.
Whang and his colleagues researched 63,469 women from the Nurses Health Study who had exhibited no earlier signs of stroke or heart disease during a follow-up between the years of 1992 and 2004. To determine which women had clinical depression, Whang and his research team gauged self-reported symptoms of depression as well as the use of antidepressant medications such as Prozac.
The women who were deemed to be the most seriously depressed were identified by the use of a 5-point mental health index score of less than 53 or because they were taking prescription antidepressants. The scientists didn't find an association between antidepressant use and fatal CHD or nonfatal heart attack . Instead , they discovered a relationship between antidepressant use and serious heart rhythm problems, including those that cause death suddenly, and without warning, from cardiac arrest.
In a statement to the media, Sanjiv M. Narayan, M.D., F.A.C.C., University of California, San Diego, who co-authored an editorial with Murray Stein, M.D., which runs along with the study in the Journal of the American College of Cardiology , said: "These data indicate the link between depression and serious heart rhythm problems may be more complex than previously thought. It raises the question of whether this association may have something to do with the antidepressant drugs used to treat depression."
Is the idea these drugs could be causing potentially deadly heart rhythm problems really such a big question? Just take a look at Prozac-maker Eli Lily's own very long and wordy package insert for physicians and you'll find a host of potential cardiac side effects:
* Frequent: hemorrhage, hypertension, palpitation
* Infrequent: angina pectoris, arrhythmia, congestive heart failure, hypotension, migraine, myocardial infarct, postural hypotension, syncope, tachycardia, vascular headache
* Rare: atrial fibrillation, bradycardia, cerebral embolism, cerebral ischemia, cerebrovascular accident, extrasystoles, heart arrest, heart block, pallor, peripheral vascular disorder, phlebitis, shock, thrombophlebitis, thrombosis, vasospasm, ventricular arrhythmia, ventricular extrasystoles, ventricular fibrillation.
(http://pi.lilly.com/us/prozac.pdf?reqNavId=undefined)
"We can't say antidepressant medications were the cause of higher risk of sudden cardiac death. It may well be that use of antidepressants is a marker for worse depression," lead researcher Whang, said in a statement to the media. "Our data raise more questions about the mechanisms by which depression is associated with arrhythmia and cardiac death."
His data raises the most questions about why scientists are tip-toeing around the obvious: SSRI antidepressants (and, in fact, other antidepressant medications in other drug families) have long been known to impact the cardiovascular system. Isn't it time to admit these drugs may literally break the hearts of those the meds are supposed to help?
http://www.rense.com/general85/anti.htm