Posted by Larry Hoover on June 30, 2009, at 8:04:26
In reply to Re: SSRI's and sudden cardiac death, posted by linkadge on June 29, 2009, at 7:52:05
> >A is depression, which leads to B, >antidepressant use, and C, sudden cardiac death.
>
> Depression doesn't necesarily lead to antidepressant use.I didn't say that it did. My meaning was "tends towards", producing a positive correlation with.
> >In fact, this study did not find any increased >risk of sudden cardiac death with antidepressant >use when not simultaneously correlated with a >diagnosis of depression. I'd say that pretty >much rules out the antidepressant having any >real contribution to sudden cardiac death.
>
> Not necessarily. The depression could be the factor that predisposes an individual to cardiac instability. The drug use can be what precipitates the event. Just like cocaine may be *relativley* safe for indivuals without heart disease. But for somebeody with a mild to severe heart problem it could lead to an adverse cardaic event. The cocaine still caused the cardiac event.
>
> LinkadgeOf course not necessarily. Your hypothesis is the most complex one possible. As a scientist, I apply my scientific training, including what has been called Occam's Razor. I'd say it like this: Unless proven otherwise, the simplest explanation is the best explanation. To quote from wiki: 'When competing hypotheses are equal in other respects, the principle recommends selection of the hypothesis that introduces the fewest assumptions and postulates the fewest entities while still sufficiently answering the question. It is in this sense that Occam's razor is usually understood. To quote Isaac Newton: "We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances."'
I can accept that you have both a different opinion, and a concern about the risk. I think it's important to consider the magnitude of the risk or mortality suggested by this study. It's very similar in magnitude to driving in a car.
I've never suggested that psychotropic drugs have no cardiac effects. I spent some time researching the subject before I allowed myself to comment on this study. In some ways, antidepressants may present cardiac risks, and in others, they are cardio-protective. There is no blanket conclusion to be drawn, as individual medical history is the most important variable to consider during drug selection.
I've got a couple of links to some full-text reports that specifically address the cardiac risk side of the yin/yang of psychotropics.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=18324881
http://www.anakarder.com/yazilar.asp?yaziid=1057&sayiid=Regards,
Lar
poster:Larry Hoover
thread:903591
URL: http://www.dr-bob.org/babble/20090630/msgs/903951.html