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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by linkadge on June 27, 2007, at 14:50:44
The following report also describes amantadine as a risk factor for developing cardiac valve damage, in addition to the two recently withdrawn dopamine agonists, (permax, and cabergoline)
http://www.medpagetoday.com/Cardiology/AcuteCoronarySyndrome/dh/4801
What I found interesting about the report was that (essentially in fine print) the study stated that while the three drugs (amantadine, permax, and cabergoline) produced the most significant cardiac dammage, even non ergot derived drugs (mirapex etc) were associated with some cardiac restructuring.
"The unexpected finding of a significantly greater mitral tenting area in the non-ergot group than in the controls could be evidence of a weak agonist effect by this entire drug class of serotonin receptors that is not sufficient to produce the valve damage observed in patients taking ergot-derived drugs, the researchers said. The mean mitral tenting area in the non-ergot group was similar to that observed in patients in the ergot group who had grade 0 to 1 valve regurgitation"
So, even the weak 5-ht2b agonist effect of mirapex for instance, caused some cardiac restructure.
I personally think the SSRI's are the next to be implicated. I wouldn't be suprised if all the SSRI's are pulled in the next 5 years.
Linkadge
Posted by saturn on June 27, 2007, at 21:32:24
In reply to amantadine also linked to cardiac valve damamge, posted by linkadge on June 27, 2007, at 14:50:44
>
>>> So, even the weak 5-ht2b agonist effect of mirapex for instance, caused some cardiac restructure.I know it's extremely uncommon but I'm a healthy young man and had severe chest pain on Zoloft, so while SSRI's are generally considered very cardio-safe, I'm also interested in this topic Link. Thanks for the post.
>
>> I personally think the SSRI's are the next to be implicated. I wouldn't be suprised if all the SSRI's are pulled in the next 5 years.I would be astounded.
Peace...Saturn.
Posted by linkadge on June 28, 2007, at 9:39:17
In reply to Re: amantadine also linked to cardiac valve damamge » linkadge, posted by saturn on June 27, 2007, at 21:32:24
What scares me the most is this: The possable connection between these drugs and this sort of problem is not so easy to spot if you aren't looking.
It is not going to jump out at you.
When the initial suspicion that the two agonists were causing problems arose, researchers had grosly underestimated the occurance of the problem.
Apparently more than a quarter of people who had taken one of the recalled agonists suffered significiant cardiac valve dammage. Their estimates were far fewer than these.
Unless a person has an echocardiogram, there is no way to detect such valve damage untill the symptoms are so severe that the valves likely need to be replaced.
Certain migrane medications are also on the list, as well as ecstacy. But SSRI's are 5-ht2b agonists plain and simple.
The reason the fenfluramine problem was detected so quickly, was that it was being used in overwieght individuals who are going to naturally have more heart problems requiring cardiac imaging.
Anyhow, I wouldn't be suprised if we see a lot more drugs being pulled in the near future.
Well, I can't say I didn't try to warn people.
Linkadge
Posted by KayeBaby on June 28, 2007, at 22:21:05
In reply to Re: amantadine also linked to cardiac valve damamge, posted by linkadge on June 28, 2007, at 9:39:17
Is Namenda related to this drug?
If so, would it have the same risks?Thanks!
Kaye
Posted by linkadge on June 30, 2007, at 10:04:38
In reply to Re: amantadine also linked to cardiac valve damamge, posted by KayeBaby on June 28, 2007, at 22:21:05
I'm not sure if they're related. They have a similar mechanism of action, but I don't think that directly implicates it.
Linkadge
Posted by kingcolon on July 11, 2007, at 10:54:35
In reply to Re: amantadine also linked to cardiac valve damamge, posted by linkadge on June 30, 2007, at 10:04:38
I have been on Requip recently, and when I read the article on possible problems with the non-ergot derivatives causing mitral valve tenting, I too was concerned. I actually stopped the Requip (unfortunately it was helping me and there really are no alternatives in this class of direct dopamine agonists that I know of).
Bromocriptine may be free of 5HT2 agonism, but it has not been very effective overall, and little testing in using it for depression.
We are left with amphetamine itself, and since I"ve had some abuse history, this isn't appropriate for me.
I'm not surprised that so little has been discussed of these findings with nonergot compounds since they are a mainstay in the treatment of Parkinson's.
Thanks for the input.
This is the end of the thread.
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