![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 19 to 43 of 43. Go back in thread:
Posted by linkadge on June 29, 2009, at 7:52:05
In reply to Re: SSRI's and sudden cardiac death » linkadge, posted by Larry Hoover on June 28, 2009, at 22:16:37
>A is depression, which leads to B, >antidepressant use, and C, sudden cardiac death.
Depression doesn't necesarily lead to antidepressant use.
>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.
Linkadge
Posted by ihatedrugs on June 30, 2009, at 1:16:33
In reply to Re: SSRI's and sudden cardiac death, posted by linkadge on June 29, 2009, at 7:52:05
Hi all,
I just came back from the hospital after having an
transient ischemic attack (mini stroke). I had a previous ischemic incident 3 years ago. This means that I have about a 65% chance of having a major stroke within a year.
I have been on every kind of ADs since I was 33 now 45. I do not smoke, eat well, exercise moderately, and have normal to lower blood pressure, high cholesterol despite eating healthy and no history of heart disease in my family.
I just weaned off Pristiq and started Savella, and have taken every ssri except Paxil.
When I had the attack on Saturday, I was actually telling my husband how much better I was feeling, went shopping and was getting ready to watch a movie when I developed numbness and pain in my left arm and then it went up the left side of the face.
Had I read this post before Saturday, I would have probably dismissed it as just another anti-depressants mudslinging posting, but this was real and it scared the daylights out of me. I have always been a healthy person except for MDD. Since I began taking ADs, I cannot say I have felt great however, they have pulled me out from some dark holes and allowed me to function for which I am greatful. But honeslty, if this research ends up being true, I am going to be fuc...g angry that not only do I have to put up with so many insidious side effects from these semi-efficent meds but now it can actually cost me my life. It would really suck! I have two young daughters a husband and extended family who were scared to death for me this weekend. It is just so not fair.
So I wouldn't be too quick to dismiss Linkadge's post and links. If it is accurate it will really be another slap on the face for a lot of us.
ihatedrugs
Posted by morganpmiller on June 30, 2009, at 3:36:39
In reply to Re: A similar study, posted by linkadge on June 29, 2009, at 7:43:12
>Do you know about the study on Zoloft giving >evidence for it's use in treating melanoma?
>It is an investigational treatment. Just like citalopram was an investigational (failed) tretment for autism.
The antidepressant sertraline downregulates Akt and has activity against melanoma cells
Kalpana K. Reddy 1 , Benjamin Lefkove 1 , Lan Bo Chen 2 , Baskaran Govindarajan 1 , Arkaitz Carracedo 3 , Guillermo Velasco 3 , Carol O. Carrillo 1 , Sulochana S. Bhandarkar 1 , Michael J. Owens 4 , Fatima Mechta-Grigoriou 5 and Jack L. Arbiser 1*
1 Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
2 Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
3 Department of Biochemistry and Molecular Biology I, School of Biology, Complutense University, Madrid, Spain
4 Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
5 Unit of Gene Expression and Diseases, CNRS URA 1644, Pasteur Institute, Paris, France
*Address correspondence to Jack L. Arbiser, e-mail: jarbise@emory.edu
Copyright Journal compilation © 2008 Blackwell Munksgaard
KEYWORDS
sertraline melanoma AKT SSRI signal transduction reactive oxygen
ABSTRACTMelanoma is a common malignancy which is poorly responsive to chemotherapy and radiation. One of the major reasons melanoma responds poorly to these modalities is constitutive expression of Akt, which protects against apoptosis. The antidepressant sertraline was found to be a potent cytotoxic agent against A375 human melanoma. To determine the mechanism by which sertraline kills melanoma cells, Western blot analysis of signaling molecules, including phosphorylated Akt, caspase 9 and phospho-p70 S6 kinase was performed. Finally, the effects of sertraline on A375 xenografts in mice were assessed. Sertaline potently inhibited the phosphorylation of Akt, and caused cell death through induction of endoplasmic reticulum in vitro. Sertraline monotherapy demonstrated activity against A375 xenografts in vivo. Akt is a major cause of resistance of melanoma to current therapy. Antidepressants are commonly used to prevent interferon-induced depression. Use of antidepressants that decrease Akt may improve the efficacy of interferon and other therapies against melanoma. Further studies are needed to elucidate whether sertraline acts as an Akt inhibitor in melanoma.
I don't think you can compare this to celexa and autism treatment
Posted by morganpmiller on June 30, 2009, at 3:42:49
In reply to Re: A similar study, posted by linkadge on June 29, 2009, at 7:43:12
Did you know that it is very possible that many >antidepressants, including SSRIs, may actually >stimulate the immune system?
>I'm sorry, is that a good thing?
You're right, we do not know exactly how SSRIs affect the immune system. And if they do boost immune function, we don't yet know if this is a good thing or a bad thing.
Depression News
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Find other articles on: "Antidepressants stimulate the immune system"Drugs that treat depression by manipulating the neurotransmitter serotonin in the brain may also affect the user's immune system in ways that are not yet understood, say scientists from Georgetown University Medical Center and a Canadian research institute.
That's because the investigators found, for the first time, that serotonin is passed between key cells in the immune system, and that the chemical is specifically used to activate an immune response. They do not know yet, however, whether these SSRI (selective serotonin reuptake inhibitors) drugs "including the brands Prozac, Zoloft, Paxil and others" could have either a beneficial or a damaging effect on human immunity.
"The wider health implication is that commonly used SSRI antidepressants, which target the uptake of serotonin into neurons, may also impact the uptake in immune cells," said Gerard Ahern, Ph.D., assistant professor of Pharmacology at Georgetown and lead researcher on the study.
He said that while it may be possible that SSRI drugs may restore a healthy immune function in people who are depressed and prone to infections, it is possible that they might also bolster immunity to the point that they trigger autoimmune disease. "At this point we just don't know how these drugs might affect immunity, so we really need to clarify the normal role of serotonin in immune cell functioning," Ahern said.
The surprising finding that serotonin is rapidly passed between immune cells in a manner similar to its transmission between brain neurons was revealed in mid-October, when the research team published the findings in the journal Blood. In December, the discovery was highlighted for the general scientific audience by the journal Nature Reviews Immunology, and now the research team is working to produce an animal model that may help describe the precise nature of this interaction.
"The novelty is that we reveal a potential communication, involving the transmitter serotonin, between immune cells that is normally only found between neurons," Ahern said.
In addition to Ahern, Peta Connell, Ph.D., from the Robarts Research Institute in Canada, was also a co-lead researcher on the study. Scientists from the Robarts Research Institute also contributed to the work.
In the brain, serotonin transmission between neurons is associated with feelings of pleasure, mood, and appetite, and the class of antidepressants known as SSRIs keeps serotonin active within the synaptic spaces between neurons, enhancing the chemical's positive effects. Unlike in the brain, which uses chemical messengers to communicate between nerve cells, the immune system is believed to "converse" through physical contact -- one type of immune cell touches another, setting off a response.
Specifically, "antigen presenting cells" display their antigens (bits of a foreign invader) to T-cells, and a resulting physical coupling between the antigens and the T-cells will prompt the T-cells to divide and expand in population, triggering an immune response designed to destroy the invader. This process may take hours.
What the Georgetown researchers found, however, is that dendritic cells -- the most powerful of the antigen-presenting cells and the ones that can find invaders that have never infected the body and "educate" the immune system to fight them -- also use serotonin to quickly excite a T-cell response. They discovered that these dendritic cells can rapidly secrete serotonin, which activates serotonin receptors on certain types of T-cells.
"In addition to the physical contact, it surprised us to find that these immune cells also have machinery to take up serotonin and to secrete it in an excitatory manner," Ahern said. "The point behind this transmission is not entirely clear, but it appears to be an additional way of stimulating a T cell response."
Drugs that block serotonin reuptake "likely change some of the parameters of T-cell activation, but we don't know yet if it enhances or inhibits the total immune response," Ahern said. "But it is something that should be explored because we really have no idea what SSRIs are doing to people's immune systems."
About Georgetown University Medical Center
Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through our partnership with MedStar Health). Our mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing and Health Studies, both nationally ranked, the world-renowned Lombardi Comprehensive Cancer Center and the Biomedical Graduate Research Organization (BGRO).
Laura Cavender
lsc6@georgetown.edu
Georgetown University Medical Center
http://gumc.georgetown.edu
Posted by morganpmiller on June 30, 2009, at 3:55:42
In reply to Re: A similar study, posted by morganpmiller on June 30, 2009, at 3:42:49
If SSRIs so far are the safest antidepressants available in terms of heart problems and there is no real proof of SSRIs being the trigger/cause of heart problems, why make such a big deal out of a few very preliminary studies? I understand the need for precaution and education. I just have to think that the millions of healthy people out there feeling pretty damn good on their SSRI, should not be too concerned about this early and fairly flimsy evidence. Until there is some hardcore proof and there are much better safer options, these studies are nothing worth worrying about. Feeling better way outweighs some unproven risk that, even if it is proven, is most likely a slight risk for a small part of the population. Sh*t, every medication carries a risk.
Antidepressants for Patients with Heart Disease
From Nancy Larson, for About.com
Updated November 08, 2008
About.com Health's Disease and Condition content is reviewed by our Medical Review Board
See More About:* antidepressants
* depression and heart diseaseSponsored Links
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(LifeWire) - In patients with heart disease, depression is more likely to lead to heart attack, stroke and chest pain than smoking, high blood pressure or even diabetes. But the odds can be evened by taking antidepressants known as selective serotonin reuptake inhibitors (SSRIs), according to a Canadian study published in the 2007 Journal of the American Medical Association.Patients who suffer depression -- around 50% of those hospitalized and as many as one-fifth of others -- are up to five times more likely to die or experience further heart problems within the next year than others.
SSRIs, such as Celexa (citalopram), Prozac (fluoxetine) and Zoloft (sertraline), are thought to improve mood by preventing nerve cells from reabsorbing serotonin, thus increasing the amount of the neurotransmitter in the brain. Having low levels of serotonin is associated with depression, so "reuptake inhibitors," by keeping more serotonin available to the brain, may relieve depression. These medications are safe for heart patients and work well for many.
According to the Journal study, SSRIs are more effective than interpersonal psychotherapy in improving depression in heart patients.
In the first few weeks of taking an SSRI, patients may actually experience increased anxiety until the the drug is fully effective -- usually in 4 to 6 weeks. Side effects that may last throughout the time the medication is taken include sexual difficulties, nausea and headache.
Some SSRIs, when paired with the antibiotic erythromycin, can increase the risk of irregular heartbeat or sudden death. Make sure the doctor who prescribes your antidepressant has a full list of any other medications you are taking.
How Depression Affects the Cardiovascular System
Controlling depression is critical for heart patients because, unchecked, it can keep the body in a chronic state of emergency preparedness. This has several serious implications:
* Increased hormone levels
* Constricted blood vessels
* Elevated heart rateEventually, this constant state of readiness damages blood vessels and desensitizes the heart to indicators that tell it to slow down.
When heart patients conquer depression, it helps decrease their perception of pain, enhances energy, improves socialization and increases their likelihood of quitting smoking, limiting alcohol consumption, exercising and eating right.
Some Harmful Antidepressants
Several antidepressants other than SSRIs can actually be dangerous for those with heart disease:
Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs), including Effexor (venlafaxine), may increase blood pressure.
Tricyclics, such as Elavil (amitriptyline), may cause dizziness and elevate heart rate.
Monoamine Oxidase Inhibitors (MAOIs), which include Nardil (phenelzine), can cause irregular heartbeat and sharply elevate blood pressure when paired with certain foods.
Posted by morganpmiller on June 30, 2009, at 4:13:46
In reply to Re: SSRI's and sudden cardiac =(just had a TIA), posted by ihatedrugs on June 30, 2009, at 1:16:33
> Hi all,
> I just came back from the hospital after having an
> transient ischemic attack (mini stroke). I had a previous ischemic incident 3 years ago. This means that I have about a 65% chance of having a major stroke within a year.
> I have been on every kind of ADs since I was 33 now 45. I do not smoke, eat well, exercise moderately, and have normal to lower blood pressure, high cholesterol despite eating healthy and no history of heart disease in my family.
> I just weaned off Pristiq and started Savella, and have taken every ssri except Paxil.
> When I had the attack on Saturday, I was actually telling my husband how much better I was feeling, went shopping and was getting ready to watch a movie when I developed numbness and pain in my left arm and then it went up the left side of the face.
> Had I read this post before Saturday, I would have probably dismissed it as just another anti-depressants mudslinging posting, but this was real and it scared the daylights out of me. I have always been a healthy person except for MDD. Since I began taking ADs, I cannot say I have felt great however, they have pulled me out from some dark holes and allowed me to function for which I am greatful. But honeslty, if this research ends up being true, I am going to be fuc...g angry that not only do I have to put up with so many insidious side effects from these semi-efficent meds but now it can actually cost me my life. It would really suck! I have two young daughters a husband and extended family who were scared to death for me this weekend. It is just so not fair.
> So I wouldn't be too quick to dismiss Linkadge's post and links. If it is accurate it will really be another slap on the face for a lot of us.
> ihatedrugs
I'm sorry to hear that you have not had much luck with SSRIs or other antidepressants.I believe that sometimes it is not one antidepressant that is causing our problems, but the fact that we have been on and off and on and off so many. One thing we have to understand with antidepressants is, if it gives us 70 percent relief and we don't have any unbearable side effect or no noticeable side effects, that is a successful trial. At that point we can do all of the other things to try to get 100 percent relief like working out, yoga, meditation, therapy, improving relationships, etc.
Also, If we are not giving the antidepressant a good 2 month trial, we may never know if it would have worked for us. If the medication is causing unbearable side effects within the firs 4 to 6 weeks and they do not go away with time or dosage adjustment, it is reasonable to stop the medication.
Many times we think a medication is pooping out. Maybe it is, maybe not. I believe we need to give it at least a month and try to make sure that other things in our life are not causing the depression. It is a common misperception that a medication is supposed to relieve all of our depression and anxiety. Unfortunately this is not true. We have to relieve all of our depression and anxiety. A medication will just enable us to do that. Sometimes a medication will nearly wipe out all symptoms. This hardly ever lasts. And if we find ourselves only getting 50 or 60 percent relief, it usually means we have to start doing all the work to get 80 to 100 percent relief.
Not sure if I articulated things well. I guess what I am trying to say is that we may find ourselves hurting our brains and bodies by being on so many different medications. If we had only been on one or two, and did everything we could to make sure we didn't go through too many trials, we may find ourselves feeling better and healthier in the long run.
Then again, some people just do not respond well and have terrible side effects to these medications. To those people I truly have sympathy and compassion.
I do have a theory about medication response. If you are healthy to begin with and eat right and stay in great shape, you may be more likely to respond well to antidepressants. And, you will be less likely to suffer any health issues in the long term.
Posted by linkadge on June 30, 2009, at 7:26:25
In reply to Re: SSRI's and sudden cardiac =(just had a TIA), posted by ihatedrugs on June 30, 2009, at 1:16:33
An excerpt from a discussion on prisiq
http://www.accessmylibrary.com/coms2/summary_0286-32743255_ITM
"In one trial, we observed a total of five cardiovascular events, namely two myocardial infarctions, or heart attacks, and three revascularizations in the Pristiq arms, and none in the placebo arm."
Linkadge
Posted by linkadge on June 30, 2009, at 7:29:21
In reply to Re: A similar study, posted by morganpmiller on June 30, 2009, at 3:36:39
Activity in mouse cells is one things. An actual human anticancer benefit is another.
In mice studies, sertraline has been linked to diabetes. Why would I take a drug that might induce a new disorder to treat melanoma which I don't have.
Linkadge
Posted by linkadge on June 30, 2009, at 7:38:17
In reply to Re: A similar study, posted by morganpmiller on June 30, 2009, at 3:55:42
Well, first of all I don't think SSRI's work all that well. Sure, some people improve on them, but many would improve on placebo too. More than half of all available clinical trial data on SSRI antidepressants fail to show a difference between active drug and the placebo.
Drug companies have worked long and hard to downplay some of the more serious side effects linked to SSRI drugs. They have been reprimanded for such activities of late. Every drug has side effects. If a priliminary study links SSRI therapy to heart attacks we should take it seriously and design safety trials to test the hypothesis. Instead, we sweep the findings under the carpet and blame them on something else. Plus, why would the drug company care? They've already got the drug approved. So long as nothing comes out to get them sued there is no problem.
Linkadge
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
Posted by bulldog2 on June 30, 2009, at 13:16:59
In reply to Re: SSRI's and sudden cardiac death » linkadge, posted by Larry Hoover on June 30, 2009, at 8:04:26
> > >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.
> >
> > Linkadge
>
> Of 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,
> LarAs always concise, succint and brilliant. You cut through the flawed argument like a sharp knife through butter.
Posted by ihatedrugs on June 30, 2009, at 15:50:29
In reply to Re: SSRI's and sudden cardiac =(just had a TIA), posted by morganpmiller on June 30, 2009, at 4:13:46
>
> I'm sorry to hear that you have not had much luck with SSRIs or other antidepressants.
>
> I believe that sometimes it is not one antidepressant that is causing our problems, but the fact that we have been on and off and on and off so many. One thing we have to understand with antidepressants is, if it gives us 70 percent relief and we don't have any unbearable side effect or no noticeable side effects, that is a successful trial. At that point we can do all of the other things to try to get 100 percent relief like working out, yoga, meditation, therapy, improving relationships, etc.
>
> Also, If we are not giving the antidepressant a good 2 month trial, we may never know if it would have worked for us. If the medication is causing unbearable side effects within the firs 4 to 6 weeks and they do not go away with time or dosage adjustment, it is reasonable to stop the medication.
>
> Many times we think a medication is pooping out. Maybe it is, maybe not. I believe we need to give it at least a month and try to make sure that other things in our life are not causing the depression. It is a common misperception that a medication is supposed to relieve all of our depression and anxiety. Unfortunately this is not true. We have to relieve all of our depression and anxiety. A medication will just enable us to do that. Sometimes a medication will nearly wipe out all symptoms. This hardly ever lasts. And if we find ourselves only getting 50 or 60 percent relief, it usually means we have to start doing all the work to get 80 to 100 percent relief.
>
> Not sure if I articulated things well. I guess what I am trying to say is that we may find ourselves hurting our brains and bodies by being on so many different medications. If we had only been on one or two, and did everything we could to make sure we didn't go through too many trials, we may find ourselves feeling better and healthier in the long run.
>
> Then again, some people just do not respond well and have terrible side effects to these medications. To those people I truly have sympathy and compassion.
>
> I do have a theory about medication response. If you are healthy to begin with and eat right and stay in great shape, you may be more likely to respond well to antidepressants. And, you will be less likely to suffer any health issues in the long term.
>
>
The reason for all the different trials is because of the drugs' inneficiency to improve symptoms or severe side effects. (30 lbs weight gain in 45 days). I do not take switching from med to med lightly. I always weigh the pros and cons and do this with my doctors full support. I believe that the main problem is that scientists are still in the dark ages in terms of what is happening to our brains and are just "shooting" at "whatever moves" to come up with something. So if a med seems to work, let's throw it out there and see how people respond. I understand that this is the best they can do but that does not mean that we are taking possibly dangerous substances at dangerously high levels in dangerous combinations while the scientific establisment waits and sees.
I have absolutely nothing to be depressed about. I am happily married 22 years, have a great family and two wonderful very smart daughters (one goes to MIT). We are financially successfull, take plenty of vacations,(most of which I can't derive any pleasure from) but I do not seem to get this monster completely off me. I have resigned to live with this disease expecting partial response from meds and celebrating my life to the best of my abilities. Perhaps the TIA was just a coincidental event and has nothing to do with my meds but it shouldn't be ignored either. It there is noise out there about some correlation between ADs and some cardiac/vascular incidents then we need to speak up and let researchers know that it may be more prevalent than they believe, and also make the medical community and patients aware of this risk.
Unfortunately, I can't stop taking Ad's as I suffer from refractory depression so I want to know everything I can about the meds I am taking.
I would love to think that these meds do more good than bad but honestly, I am not so sure about that...only time will tell.
Thanks for your post
ihatedrugs
Posted by linkadge on June 30, 2009, at 17:48:43
In reply to Re: SSRI's and sudden cardiac death, posted by bulldog2 on June 30, 2009, at 13:16:59
>As always concise, succint and brilliant. You >cut through the flawed argument like a sharp >knife through butter.
I suppose mine is the flawed argument? I don't think Larry suggested my argument was flawed.
Linkadge
Posted by bulldog2 on June 30, 2009, at 17:54:57
In reply to Re: SSRI's and sudden cardiac death, posted by linkadge on June 30, 2009, at 17:48:43
> >As always concise, succint and brilliant. You >cut through the flawed argument like a sharp >knife through butter.
>
> I suppose mine is the flawed argument? I don't think Larry suggested my argument was flawed.
>
> Linkadge.
>
>No reference to your arguments. However I felt Larry had a brilliant response to the studies conclusions.
Posted by morganpmiller on June 30, 2009, at 21:18:03
In reply to Re: SSRI's and sudden cardiac =(just had a TIA), posted by linkadge on June 30, 2009, at 7:26:25
Pristiq is not an SSRI. Didn't that one article I posted say there was an increased risk with effexor? Effexor and Pristiq are like Lexapro and Celexa, very similar.
Posted by morganpmiller on June 30, 2009, at 21:28:00
In reply to Re: A similar study » morganpmiller, posted by linkadge on June 30, 2009, at 7:29:21
> Activity in mouse cells is one things. An actual human anticancer benefit is another.
>
> In mice studies, sertraline has been linked to diabetes. Why would I take a drug that might induce a new disorder to treat melanoma which I don't have.
>
> Linkadge
>
>
I guess I was trying to point out that we may find benefits to antidrepressants for some people that we were not aware of before. Just like we may find risks that we were not aware of before.Any number of things can cause diabetes. I doubt that a normal healthy person that takes care of themselves is going to develop diabetes solely due to the fact that they have take Zoloft for several years. I think people need to learn how to take care of themselves. That seems to be more the issue here.
What if you were had a lot of sun damage over the years and Zoloft helped prevent melanoma from developing? I know I am speaking hypothetically. Maybe we will find out in the next few years that zoloft could act in a protective way against the development of melanoma. Just like maybe all SSRIs or at least a few of them carry the risk of making a certain part of the population more prone to sudden cardiac death. Who knows. No medication comes without risk, at least not in these early days of modern medicine.
Posted by Phillipa on June 30, 2009, at 21:32:53
In reply to Re: SSRI's and sudden cardiac =(just had a TIA), posted by ihatedrugs on June 30, 2009, at 15:50:29
Ihatedrugs your experience should be taken very seriously as so many pdocs don't have the foggiest except what drug reps tell them. Of course there are many that are great docs. I feel for you and let me know if I can help in any way. This just bothers me as when doing psych nursing a patient came in on one med and left on about a dozen was it necessay? They often returned time after time in worse condition than after their first admission. That's my experience anyway. More than one hospital also. What interracts with what? Phillipa
Posted by morganpmiller on June 30, 2009, at 21:55:03
In reply to Re: SSRI's and sudden cardiac =(just had a TIA), posted by ihatedrugs on June 30, 2009, at 15:50:29
Have you ever tried any kind of therapy? You don't have to have anything to be depressed about on the outside for something lingering underneath the surface on the inside to come back and keep bringing you down. The best explanation for depression is the bio/psycho/social dynamic. Psychiatrists and big pharma would rather us not delve into the past and deal with things, because if we did, we may not eventually need to be medicated as much.
There is neurofeedback, EMDR, CBT, and other alternative therapies/treatments that may help you address the rest of your depression that medication alone will not address.
I hear your concerns about medications. I often feel the same way. I do believe that if I had just stayed on zoloft, continued with therapies and kept working out and eating right, I would not feel as bad as I do today.
Your so right about psychiatry being in the dark ages. Still, considering how young psychiatry is, it is pretty amazing that the medications that are available today work as well as they do for so many.
> >
> > I'm sorry to hear that you have not had much luck with SSRIs or other antidepressants.
> >
> > I believe that sometimes it is not one antidepressant that is causing our problems, but the fact that we have been on and off and on and off so many. One thing we have to understand with antidepressants is, if it gives us 70 percent relief and we don't have any unbearable side effect or no noticeable side effects, that is a successful trial. At that point we can do all of the other things to try to get 100 percent relief like working out, yoga, meditation, therapy, improving relationships, etc.
> >
> > Also, If we are not giving the antidepressant a good 2 month trial, we may never know if it would have worked for us. If the medication is causing unbearable side effects within the firs 4 to 6 weeks and they do not go away with time or dosage adjustment, it is reasonable to stop the medication.
> >
> > Many times we think a medication is pooping out. Maybe it is, maybe not. I believe we need to give it at least a month and try to make sure that other things in our life are not causing the depression. It is a common misperception that a medication is supposed to relieve all of our depression and anxiety. Unfortunately this is not true. We have to relieve all of our depression and anxiety. A medication will just enable us to do that. Sometimes a medication will nearly wipe out all symptoms. This hardly ever lasts. And if we find ourselves only getting 50 or 60 percent relief, it usually means we have to start doing all the work to get 80 to 100 percent relief.
> >
> > Not sure if I articulated things well. I guess what I am trying to say is that we may find ourselves hurting our brains and bodies by being on so many different medications. If we had only been on one or two, and did everything we could to make sure we didn't go through too many trials, we may find ourselves feeling better and healthier in the long run.
> >
> > Then again, some people just do not respond well and have terrible side effects to these medications. To those people I truly have sympathy and compassion.
> >
> > I do have a theory about medication response. If you are healthy to begin with and eat right and stay in great shape, you may be more likely to respond well to antidepressants. And, you will be less likely to suffer any health issues in the long term.
> >
> >
> The reason for all the different trials is because of the drugs' inneficiency to improve symptoms or severe side effects. (30 lbs weight gain in 45 days). I do not take switching from med to med lightly. I always weigh the pros and cons and do this with my doctors full support. I believe that the main problem is that scientists are still in the dark ages in terms of what is happening to our brains and are just "shooting" at "whatever moves" to come up with something. So if a med seems to work, let's throw it out there and see how people respond. I understand that this is the best they can do but that does not mean that we are taking possibly dangerous substances at dangerously high levels in dangerous combinations while the scientific establisment waits and sees.
> I have absolutely nothing to be depressed about. I am happily married 22 years, have a great family and two wonderful very smart daughters (one goes to MIT). We are financially successfull, take plenty of vacations,(most of which I can't derive any pleasure from) but I do not seem to get this monster completely off me. I have resigned to live with this disease expecting partial response from meds and celebrating my life to the best of my abilities. Perhaps the TIA was just a coincidental event and has nothing to do with my meds but it shouldn't be ignored either. It there is noise out there about some correlation between ADs and some cardiac/vascular incidents then we need to speak up and let researchers know that it may be more prevalent than they believe, and also make the medical community and patients aware of this risk.
> Unfortunately, I can't stop taking Ad's as I suffer from refractory depression so I want to know everything I can about the meds I am taking.
> I would love to think that these meds do more good than bad but honestly, I am not so sure about that...only time will tell.
> Thanks for your post
> ihatedrugs
Posted by ihatedrugs on July 1, 2009, at 1:14:51
In reply to Re: SSRI's and sudden cardiac =(just had a TIA), posted by morganpmiller on June 30, 2009, at 21:55:03
> Have you ever tried any kind of therapy? You don't have to have anything to be depressed about on the outside for something lingering underneath the surface on the inside to come back and keep bringing you down. The best explanation for depression is the bio/psycho/social dynamic. Psychiatrists and big pharma would rather us not delve into the past and deal with things, because if we did, we may not eventually need to be medicated as much.
>
> There is neurofeedback, EMDR, CBT, and other alternative therapies/treatments that may help you address the rest of your depression that medication alone will not address.
Actually, I have but I guess I haven't found the right therapist. The onset of my depression was very sudden. One day I was perfectly fine and then one morning I awoke to the most dreadful feeling of doom and it wouldn't go away. I was nineteen at the time and was away in college but was very happy until that day. I suffered in silence for many years because I did'nt know what was wrong with me. I believe had I gotten help early on perhaps it would have been an easier ride. But who knows. I do remember however in the midst of my first depressive episode I mustered the strenght to go to a psychotherapist using the last fifty dollars I had in my bank account, and all I remembered the therapist telling me was to clean my closet or organize the kitchen cabinets to keep my mind busy so I wouldn't think about the depression. It was at that time that the only one lucid thought left in my mal functioning brain screamed...what a bunch of crock...I want my fifty dollars back... I need to pay my roomate. Of course never saw her again. It sounds funny now but at the time I was so confused.I guess the point we are all trying to make with this discussion is that there is no panacea for our mental ills and some of us have been suffering longer than others which takes a toll. Yet, some of us choose to be more hopeful and believe that these meds will eventually get better with time and we just need to be patient. Most of our bloggers log into this forum looking for that magic post that says "scientists have found the magic bullet to treat and cure depression" but in the meantime we decide to share our frustrations, fears and knowledge with people who are actually interested in listening to us.
And usually when we find a med that works (if only for a while) we don't lurk as much and sometimes don't even visit the site because we are too busy enjoying life.ihatedrugs
Posted by morganpmiller on July 1, 2009, at 1:39:37
In reply to Re: SSRI's and sudden cardiac =(just had a TIA), posted by ihatedrugs on July 1, 2009, at 1:14:51
Yeah that first therapist you saw sounds like I bit of quack. Maybe he/she was just trying to get you to organized your environment so that you may have an easier time organizing your mind in a way that you needed in order to start dealing with some things. Who knows. That's unfortunated that you had a bad experience the first time you saw a therapist. That time of our lives is not a time when people typically have success in dealing with the possible underlying causes of their depression, whether the therapist is good or not. I am a huge believer that most of us were not simply born with depression. We have it lurking inside of us for reasons other than biological and one day something triggers it and it comes to the surface.
What you say about medication makes a lot of sense. I will say that even when cleaner, more effective medications are developed in the future, we still won't truly rid ourselves of the illness unless we deal with the root causes. Otherwise we will just be covering up what is really going on deep inside. Sure there are biological predispositions. Those predispositions most likely would not turn into the monsters they become if it were not for the emotional elements of our psyche plaguing our subconscious.
IMHO, the medications available today, plus therapy, is the best approach to treating depression/anxiety in the long run.
I'll take my antidepressants and take care of my body and go to therapy and live a long healthy life. You guys can jump on the wagon if you want to.
> Have you ever tried any kind of therapy? You don't have to have anything to be depressed about on the outside for something lingering underneath the surface on the inside to come back and keep bringing you down. The best explanation for depression is the bio/psycho/social dynamic. Psychiatrists and big pharma would rather us not delve into the past and deal with things, because if we did, we may not eventually need to be medicated as much.
> >
> > There is neurofeedback, EMDR, CBT, and other alternative therapies/treatments that may help you address the rest of your depression that medication alone will not address.
>
>
> Actually, I have but I guess I haven't found the right therapist. The onset of my depression was very sudden. One day I was perfectly fine and then one morning I awoke to the most dreadful feeling of doom and it wouldn't go away. I was nineteen at the time and was away in college but was very happy until that day. I suffered in silence for many years because I did'nt know what was wrong with me. I believe had I gotten help early on perhaps it would have been an easier ride. But who knows. I do remember however in the midst of my first depressive episode I mustered the strenght to go to a psychotherapist using the last fifty dollars I had in my bank account, and all I remembered the therapist telling me was to clean my closet or organize the kitchen cabinets to keep my mind busy so I wouldn't think about the depression. It was at that time that the only one lucid thought left in my mal functioning brain screamed...what a bunch of crock...I want my fifty dollars back... I need to pay my roomate. Of course never saw her again. It sounds funny now but at the time I was so confused.
>
> I guess the point we are all trying to make with this discussion is that there is no panacea for our mental ills and some of us have been suffering longer than others which takes a toll. Yet, some of us choose to be more hopeful and believe that these meds will eventually get better with time and we just need to be patient. Most of our bloggers log into this forum looking for that magic post that says "scientists have found the magic bullet to treat and cure depression" but in the meantime we decide to share our frustrations, fears and knowledge with people who are actually interested in listening to us.
> And usually when we find a med that works (if only for a while) we don't lurk as much and sometimes don't even visit the site because we are too busy enjoying life.
>
> ihatedrugs
>
>
Posted by linkadge on July 1, 2009, at 7:59:54
In reply to Re: SSRI's and sudden cardiac =(just had a TIA), posted by morganpmiller on June 30, 2009, at 21:18:03
I realize that pristiq isn't an SSRI, but the one poster was taking pristiq so I thought I'd mention it.
Linkadge
Posted by linkadge on July 1, 2009, at 8:07:36
In reply to Re: A similar study, posted by morganpmiller on June 30, 2009, at 21:28:00
>I guess I was trying to point out that we may >find benefits to antidrepressants for some >people that we were not aware of before. Just >like we may find risks that we were not aware of >before.
Yes, that is the premise of my arguemnt.
>Any number of things can cause diabetes. I doubt >that a normal healthy person that takes care of >themselves is going to develop diabetes solely >due to the fact that they have take Zoloft for >several years. I think people need to learn how >to take care of themselves. That seems to be >more the issue here.There you go trying to excuse away potential dangers yet harping on about potential benefits. People have developed diabeties *solely* as the result of say zyprexa. Psychiatric medications can screw up your metabolism (zyprexa as a prime example). No not everybody is going to get diabetes, but some are - thats why lawsuits have been won against Lilly. To say that nobody will get diabetes on zyprexa if they just take care of thesmelves is a little inacurate. The same may be true for zoloft - we don't know unless we study further.
This logic - "I highly doubt that somebody will ever get sick as a result of drug x, so long as they take care of themselves" is very weak.
Perhaps I "highly doubt" that zoloft will really prove to be beneficial for cancer. It could be however, I don't know and unless it is researched further nobody will ever know.
Linkadge
Posted by Larry Hoover on July 1, 2009, at 9:15:39
In reply to Re: A similar study, posted by linkadge on July 1, 2009, at 8:07:36
> People have developed diabeties *solely* as the result of say zyprexa. Psychiatric medications can screw up your metabolism (zyprexa as a prime example). No not everybody is going to get diabetes, but some are - thats why lawsuits have been won against Lilly.
This isn't directed at you, Link. I feel a rant coming on.
I do not accept the premise that Zyprexa causes diabetes. It does, however, affect glucose metabolism. The problem is not with the drug, it is with the medical management of the patient.
By no means am I minimizing the consequences of weight gain and diabetes associated with prolonged Zyprexa intake. But why was the patient permitted to progress to a serious state of medical abnormality without intervention?
And how is that the fault of the drug manufacturer? Post-marketing surveillance isn't an instantaneous process. It takes time to realize that there may be a significant concern that needs to be brought forward in public warnings, etc. However, no one on this planet has ever developed diabetes overnight. Where were the doctors in all of this?
Just for the record, some may think I am pro-Big Pharma, biased and selective in my interpretations. That is flat out false. I am a scientist, with many years of professional experience in the critical analysis of other people's scientific work. And I calls 'em as I sees 'em.
Just a few of my own drug experiences....
1. In only 11 days on Serzone, I was rendered so stupified that I could not avoid walking into a telephone pole adjacent to a sidewalk seven feet wide, knocking myself to the pavement. I made it back to my car and proceeded to drive through at least two red lights, totally oblivious to my state. I discontinued the medication.
2. In 42 days on Remeron, I gained 30 lbs. I shop and cook for myself, and I did not change my eating habits, portion size, or anything like that. My doctor simply said that my weight gain was not possible. I had to buy new clothes, and it took me a year to get the weight off. I discontinued the drug.
3. In less than two weeks on Lamictal, I developed oligohydrosis, the complete inability to sweat. I detected this condition while driving my black car (no air conditioning) during a heat wave, realizing that I was showing signs of heat stroke. I somehow made it to an air conditioned environment, where I collapsed. I have no recollection of how I made it there, or how long it took me to come to my senses. I discontinued the medication.
4. In three weeks on Neurontin, I lost the ability to produce speech, and had such profound episodic sensory disturbances that I could neither see nor walk. I discontinued the medication.
There are others, too.
I am very sensitive to medication. What I will not do is generalize from my experience, because it appears to be inconsistent with that of the far larger numbers of those who tolerate the medications well. And I do not blame anyone for my poor outcomes. The medications were prescribed to me in good faith, for the treatment of conditions for which I was seeking help. It didn't work out as predicted. End of story.
Lar
Posted by bulldog2 on July 1, 2009, at 15:03:51
In reply to Re: A similar study, posted by Larry Hoover on July 1, 2009, at 9:15:39
> > People have developed diabeties *solely* as the result of say zyprexa. Psychiatric medications can screw up your metabolism (zyprexa as a prime example). No not everybody is going to get diabetes, but some are - thats why lawsuits have been won against Lilly.
>
> This isn't directed at you, Link. I feel a rant coming on.
>
> I do not accept the premise that Zyprexa causes diabetes. It does, however, affect glucose metabolism. The problem is not with the drug, it is with the medical management of the patient.
>
> By no means am I minimizing the consequences of weight gain and diabetes associated with prolonged Zyprexa intake. But why was the patient permitted to progress to a serious state of medical abnormality without intervention?
>
> And how is that the fault of the drug manufacturer? Post-marketing surveillance isn't an instantaneous process. It takes time to realize that there may be a significant concern that needs to be brought forward in public warnings, etc. However, no one on this planet has ever developed diabetes overnight. Where were the doctors in all of this?
>
> Just for the record, some may think I am pro-Big Pharma, biased and selective in my interpretations. That is flat out false. I am a scientist, with many years of professional experience in the critical analysis of other people's scientific work. And I calls 'em as I sees 'em.
>
> Just a few of my own drug experiences....
>
> 1. In only 11 days on Serzone, I was rendered so stupified that I could not avoid walking into a telephone pole adjacent to a sidewalk seven feet wide, knocking myself to the pavement. I made it back to my car and proceeded to drive through at least two red lights, totally oblivious to my state. I discontinued the medication.
>
> 2. In 42 days on Remeron, I gained 30 lbs. I shop and cook for myself, and I did not change my eating habits, portion size, or anything like that. My doctor simply said that my weight gain was not possible. I had to buy new clothes, and it took me a year to get the weight off. I discontinued the drug.
>
> 3. In less than two weeks on Lamictal, I developed oligohydrosis, the complete inability to sweat. I detected this condition while driving my black car (no air conditioning) during a heat wave, realizing that I was showing signs of heat stroke. I somehow made it to an air conditioned environment, where I collapsed. I have no recollection of how I made it there, or how long it took me to come to my senses. I discontinued the medication.
>
> 4. In three weeks on Neurontin, I lost the ability to produce speech, and had such profound episodic sensory disturbances that I could neither see nor walk. I discontinued the medication.
>
> There are others, too.
>
> I am very sensitive to medication. What I will not do is generalize from my experience, because it appears to be inconsistent with that of the far larger numbers of those who tolerate the medications well. And I do not blame anyone for my poor outcomes. The medications were prescribed to me in good faith, for the treatment of conditions for which I was seeking help. It didn't work out as predicted. End of story.
>
> Lar
>
>Again well put Larry and I would like to add some addtional points:
1. Some in this room attack psychotropic drug and isolate them as if they are uniquely evil. All drugs are powerful agents and can create side effects that range from mild to life threatening. I may be able to gobble advil like candy without any problem where others might be one of 16,500 a year who die from nsaids.
2. Testing(all drugs) may be done in a scientific
moral way and may not find all potentially serious sides until the drug has been released and used for a while. I don't think there is any conspiracy to use us as guinea pigs. I don't think big pharm enjoys these massive class action law suits.3. Big Pharm companies get critisized all the time for taking to long to release drugs that are waited for. So they're in a no win situation. Some say they test to long and others say they don't test enough.
4. People have allergic reaction to peanuts and die.5. Drugs can be dangerous. So don't take them if you fear sides. But these conspiracy theories and there's anything uniquely dangerous about psych drugs just don't hold water.
6. Under capitalism you make money by making the best product you can produce. The product may be very flawed in the end but not done intentionally. Law Suits cost the companies millions in the end and damage their reputation.
7. If I'm that anti-drug I just stop taking them. If I take them I understand the risk I'm taking. I take them because I just have not found alternative medicine to be effective. To many quacks making unsubstantiated claims. I have spend money by the bucket load on alternative supps and methods that just plain did not work. So what am I left with? Allopatic medicine that is flawed but yields more results than alternative med.
Posted by rskontos on July 1, 2009, at 22:32:30
In reply to Re: A similar study, posted by bulldog2 on July 1, 2009, at 15:03:51
need to stop Wellbutrin because I am already having some blood pressure issues, although heart rate not bad.
This is more than I can, in my present state of panic attacks, and extreme health issues can understand.
So do I completely taper off. I have started to titrate down.
Due to blood pressure issues p-doc thought I should see if it would help to lower dosage.
Now if this study/studies are correct, I could be in danger.
I can't really figure out if Wellbutrin is a SSRI. It seems some sites call it a hard to figure anti-depressant.
rsk
This is the end of the thread.
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