Posted by Larry Hoover on June 28, 2009, at 18:34:43
In reply to SSRI's and sudden cardiac death, posted by linkadge on June 28, 2009, at 10:41:06
> I understand this is a biased site, but it refers to another credable study. Women who took antidepressants had a higher risk of sudden cardiac death which was not accounted for by depression sevarity.
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> http://www.beforeyoutakethatpill.com/index.php/2009/03/10/theyre-dropping-like-flies-on-their-ssris/
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> Thoughts?
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> LinkadgeWell, to their credit, they did provide a link to the full-text of the underlying study. http://www.beforeyoutakethatpill.com/2009/3/depression_cardiac_death.pdf
I agree with the article's authors that it is not possible to determine the influence of antidepressants on the risk of sudden cardiac death. It mis-states the results to express anything else.
In the discussion: "Because antidepressant use more significantly correlated with a diagnosis of clinical depression than the MHI-5 score, it is entirely possible that antidepressant use identified participants with more severe depression that was not fully captured by the MHI-5 questionnaire. In addition, these risks need to be put in perspective and balanced against known benefits of these medications on depression. Sudden cardiac death among healthy women is an uncommon event, and although elevated, the absolute risk among women who reported antidepressant use in this study was still very low (46 SCDs/100,000 person-years)."
And I think the very brief 'Conclusions' statement is quite appropriate: "In this prospective cohort of women without baseline cardiovascular disease, we found that symptoms of depression are associated with higher risks of cardiac events, and at least part of this association seems to be explained by differences in coronary risk factors, which might act as causal intermediates in the risk conferred by depression. When we used a proxy for clinical depression, which included antidepressant medication use, we observed a stronger association for SCD, suggesting a possible proarrhythmic mechanism. Although antidepressant medication use might be a marker of worse depression, its specific association with elevated risk of SCD merits further study."
In brief, the study found an association between *depression* and cardiac events, but especially with sudden cardiac death. The specific influence of antidepressant medication in this outcome cannot be determined, because antidepressant use is itself associated with depression.
Lar
poster:Larry Hoover
thread:903591
URL: http://www.dr-bob.org/babble/20090620/msgs/903658.html