Antidepressants linked to sudden death

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Wednesday, March 11, 2009

Antidepressants

Linked to Sudden Death in Women

by: Sherry Baker

Research just published in the March 17, 2009, issue of the Journal of the

American College of Cardiology links depression to sudden cardiac death (SCD)

and fatal coronary heart disease (CHD) in women with no known heart problems. But if you read the research carefully, it reveals another

startling link: The study found the women with the highest risk for SCD and

fatal CHD had the most depressive symptoms or were taking antidepressants.

" 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, M.D., M.S., Division of Cardiology, Columbia University Medical Center,

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. " However, according to Whang's own research, the risk of cardiac

death was associated more strongly with taking antidepressant drugs than with

symptoms of clinical depression.

Whang and his research team studied 63,469 women from the

Nurses Health Study who had no evidence of previous stroke or heart disease

during a follow-up between the years of 1992 and 2004. To find out which women

suffered from depression, Whang and his colleagues looked at self-reported

symptoms of depression and the use of antidepressant medications such as

Prozac. Women with the most serious clinical depression were identified by the

use of a 5-point mental health index score of less than 53 or by the fact they

took antidepressants regularly.

No relationship was noted between antidepressant use and

fatal CHD or nonfatal heart attack -- but a link between serious heart rhythm

problems, including those that cause sudden death, was found. According to the

American Heart Association, SCD (also know as cardiac arrest or heart arrest)

causes unexpected, sudden death from an abrupt loss of heart function.

" 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, " Sanjiv M. Narayan,

M.D., F.A.C.C., University of California, San Diego, who co-authored the

accompanying editorial with colleague, Murray Stein, M.D., said in a statement

to the media.

Both Dr. Whang and Dr. Narayan stated in the media

release that the relationship between antidepressant medicines and sudden

cardiac death needs more research to determine whether antidepressant

medications directly increase the risk for deadly heart rhythm disorders, but

they claim the benefits of " appropriately prescribed " antidepressants

outweigh the risk of sudden cardiac death.

" 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, " adds Dr. Whang.

" Our data raise more questions about the mechanisms by which depression is

associated with arrhythmia and cardiac death. "

However, the truth is that although SSRI antidepressants

(such as Prozac, Lexapro, Zoloft, Paxil and others) are generally described as

safe for the heart , a host of cardiovascular side effects -- including

irregular heart rhythms and even potentially lethal arrhythmias -- have long

been known to occur in some people taking the drugs. In fact, Eli Lily, the

drug company behind Prozac, lists these cardiovascular side effects, including

heart arrest, on their official package insert for physicians:

* 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.