The researchers collected data from 136,000 participants that were not taking antidepressant medications when they first began the study. It was noted during their first follow up between one and three years later that roughly 5,500 of those women had begun taking antidepressants. “The research team compared that group's subsequent history of cardiovascular disease with that of participants who had not started taking antidepressants.”
Results showed that the women taking antidepressants had a small, but statistically significant increased risk of stroke and/or death compared to participants declaring that they were not taking antidepressants.
Lead author, Jordan W. Smoller, MD, ScD, of the Massachusetts General Hospital (MGH) Department of Psychiatry, explains that although it is necessary to treat depression because it is a serious illness, it is equally important for older women to discuss their treatment options with their physician before committing to one because of the various risks involved.
The DSM IV defines depression as experiencing feelings of sadness, helplessness and hopelessness. It is a state of low mood and aversion to activity. Episodes of depressed mood are a core feature in various psychological disorders.
Some symptoms of depression can include:
- Sleep disturbances
- never seem to be enough
- chronic sadness never seeming to end
- shakiness when feeling most down
- mood swings
Side effects: Fatigue, dry mouth, blurred vision, light-headedness
Side effects: Nausea, gastrointestinal upset, sleep disturbances, headache, agitation
Side effects: Insomnia, headache, constipation
Side effects: Fatigue, light-headedness, nausea, headache
Side effects: Nausea, agitation, sweating
- Phenelzine (Nardil)
- Tranylcypromine (Parnate)
- Isocarboxazid (Marplan)
- Selegiline (Emsam)
Side effects: Drowsiness, Constipation, Nausea, Diarrhea, Stomach upset, Fatigue, Dry mouth, Dizziness, Low blood pressure, Light-headedness, Decreased urination, Decreased sexual function, Sleep disturbances, Muscle twitching, Weight gain, Blurred vision, Headache, Increased appetite, Restlessness, Shakiness, Trembling, Weakness, Increased sweating
Although no relationship was established between antidepressant use and heart disease, follow-up appointments nearly six years later indicated that participants using antidepressants had an increased risk of death and those treated with SSRIs had an increased risk of stroke.
Even though results seem frightening it seems to me that further investigation is needed as there are several problems with this study. The researchers have not distinguished whether the problem really lies within the link between antidepressants and cardiovascular disease or depression itself and cardiovascular disease. Prior studies will show that depression has risks that are just as high as those who use antidepressants in this study. If anything, the study may indicate that treatment with antidepressants could exacerbate those risks. After careful review of this study, it seems difficult to place blame on antidepressants, but more could be revealed with further investigation.
Additionally, the study does not specify whether these women were being treated for depression or for anxiety nor is there any indication that lifestyle factors such as stress, smoking or diet have been accounted for. Furthermore, the study is too group-specific; therefore it cannot suggest that results can be generalized to the other populations, such as men or premenopausal women unfortunately.
Despite the lack of concrete evidence, it seems logical that women with cardiovascular risks would benefit from exploring treatment options other than antidepressants, but in the end, for most, the benefits of antidepressants may far outweigh the costs.
Increased Risk of Death, Stroke in Postmenopausal Women Taking Antidepressants, Study Finds
Monoamine Oxidase Inhibitors
Medications for Treating Depression
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