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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Iris on August 22, 1999, at 21:48:28
I'm approaching 10years of antidepressant use for severe depression. I have taken several different types. I would like to know how using these medications may affect my health in the long run. It's a matter of I can't live without them but, can I live long with them without ruining my health?
Posted by Danny on August 22, 1999, at 23:27:56
In reply to what happens with long term antidepressant use?, posted by Iris on August 22, 1999, at 21:48:28
> I'm approaching 10years of antidepressant use for severe depression. I have taken several different types. I would like to know how using these medications may affect my health in the long run. It's a matter of I can't live without them but, can I live long with them without ruining my health?
This is a good question. I've been on desipramine, then Paxil for most of the decade. My instinct, of course, is that we're better off without any drugs. But... that has to be balanced against quality of life in the long run. I haven't seen much written about this issue and I wonder if we're still too early in the history of these drugs for clinical judgements.
Posted by Linnie on August 23, 1999, at 7:03:13
In reply to what happens with long term antidepressant use?, posted by Iris on August 22, 1999, at 21:48:28
Dr Bob or someone else might be able to put people's mind to rest on this better than I, but I can relate my personal experience.e
From being on Elavil for 16 years ( I am now on Celexa for 8 months ) I developed an arythmia in my heart. It is not serious as I have been told it is an "acquired" condition from the medication and not one I inherited or developed from other things.
Basically the QT interval on my EKG is elongated, almost to the danger point. It was discovered by accident when I collapsed from anemia and they had to rule out the cause for it.
Even getting off the Elavil has not made it return to normal but my heart does not gallop after one of these "missed beats" so it seems a "not to worry" situation. My GP does watch it regularly though and I probably have more than the normally required EKGs but better safe than sorry.
I am past worry about it, in my case, as everything I have been told about it in my case has proven out.
Posted by Roo on August 23, 1999, at 8:06:49
In reply to Re: what happens with long term antidepressant use?, posted by Linnie on August 23, 1999, at 7:03:13
I have no scientific input on this, but I worry
about the same thing. When I go off meds and get
depressed and start talking about this stuff with
my Mom (being worried about longterm use), she
reminds me that living with untreated depression
can have bad long term effects too. What happens
to the body of a spirit that's constantly unhappy?
They link anger and unhappiness to cancer and other
diseases....also heart disease and depression can
be linked...
Posted by Carmen on August 23, 1999, at 12:06:03
In reply to what happens with long term antidepressant use?, posted by Iris on August 22, 1999, at 21:48:28
> I'm approaching 10years of antidepressant use for severe depression. I have taken several different types. I would like to know how using these medications may affect my health in the long run. It's a matter of I can't live without them but, can I live long with them without ruining my health?
Iris: I was on Prozac for 4 yr. and Paxil for the same. Had to go off because I was becoming manic - Dr. didn't know if it was drug-induced or that I have a problem that way. I'm not saying that that is going to happen to you. He then put me on Depakote for mood stabilizing. I've learned that some people just need the help of the anti-depressants to maintain their mental health. Nothing wrong w/that. Just like a diabetic, etc. Your Dr. would be the best source of answer to your concerns. Best to you! Carmen
Posted by yardena on August 23, 1999, at 21:42:23
In reply to Re: what happens with long term antidepressant use?, posted by Carmen on August 23, 1999, at 12:06:03
I am not up to speed on how being on long term antidepressants can affect your health. But I have read about the long term effects of stress, and increased cortisol in your system. There is a great book called "Why Zebras Don't Get Ulcers". I forget the authors name, but I can post it tomorrow (the book is in a box in the trunk of my car). This guy is a physiologist and he is very amusing. He explains how we have the same stress response as Zebras, but the stress response is suited to the kind of stress the Zebra has to contend with and not to the kind of stress we usually contend with. The Zebra needs to respond to acute life threatening stress, whereas we tend to have long term social stress. So, our bodies secrete cortisol and other hormones that would help us run like hell from a hungry lion, but only damage our bodies because we are not running like hell from hungry lions. I also saw this same physiologist on a PBS documentary series on the brain, and they showed him doing research on baboons (I think it was baboons, but I am not literate in primate species)in Africa. Apparently this one species has great living conditions--abundant food and water, no predators, etc. So what do they do? They do what we do--they create their own form of stress, ie, social stress. This is in the form of hierarchies. And it turns out that the lower status animals are depressed, look and act depressed, and when they measured their cortisol levels they were very high. They also had actual damage from the cortisol--they stopped growing, loss bone and muscle, etc. Apparently, high levels of cortisol is also well documented in depressed people.
The way I understand it is, the cortisol helps to supress growth and maintenance of the body tissues, because in an acute stress situation, the Zebra needs to activate energy for immediate use and not store it for later. But, luckily for the Zebra, the stress is acute and subsides, so it can return to building and maintaining itself. But for us chronically stressed and depressed folks, the chronic secretion of cortisol just wears away at our bodies and immune systems, etc.
So, I guess even though I, too worry about the effects of long term antidepressant use, I also know that my long term depression is probably just as, if not more, damaging. Aside from the fact that when untreated, my depression can be so crushing that life seems unbearable at all. Do I really have a choice?????
Posted by Yardena on August 23, 1999, at 21:45:32
In reply to what happens with long term antidepressant use?, posted by Iris on August 22, 1999, at 21:48:28
I just wanted to add---great topic, thanks for starting it. If anyone knows more about this, please fill us in!!!!
Posted by dj on August 25, 1999, at 10:39:57
In reply to what happens with long term antidepressant use?, posted by Iris on August 22, 1999, at 21:48:28
From http://www.drkoop.com/healthnews/rhn0618/t061810.asp
Health News for June 18, 1999
Depression linked to physical changes in brain
NEW YORK, Jun 18 (Reuters Health) -- Depression appears to affect the size of an area of the brain involved in learning and memory, report US researchers.This area, called the hippocampus, tends to be smaller in people with a history of depression according to a new study.
In a study of 24 women ranging in age from 23 to 86 with a history of depression and 24 women with no such history, those with a history of depression had 9 to 13% smaller hippocampal volumes.
Study participants who had more bouts with depression had even smaller hippocampal volumes than those women who reported fewer episodes of depression, report a research team led by Dr. Yvette L. Sheline, a psychiatrist at Washington University School of Medicine in St. Louis. Their findings are published in The Journal of Neuroscience.
The study involved using magnetic resonance imaging (MRI) to take three-dimensional pictures of the women's brain. They also found that a specific area in another brain structure associated with emotion, the amygdala, were smaller in women with a history of depression.
On average, women in the study experienced about five bouts of depression, with one women reporting 18 bouts of depression, the researchers wrote.
The more bouts of depression, the smaller the hippocampus in depressed patients, the team report.
Women with a history of depression also scored lower on a test measuring verbal memory, a key function of the hippocampus.
Researchers speculated that advanced age may promote volume loss in the hippocampus, but the new results suggest that depression alone is responsible for the smaller volumes.
Exactly how smaller hippocampal volumes are linked to depression is unclear, but previous research suggests that depressed people make too much cortisol, a stress hormone needed for hippocampal function. Sheline and colleagues hypothesize that high levels of stress hormones may have toxic effects on the hippocampus.
"The finding that depression can result in volume loss and that more depression can result in even greater volume loss underscores the importance of treating and preventing depression," Sheline and colleagues note in a statement
"Treatment not only can prevent suffering and restore quality of life. It also appears that treating depression may limit long-term damage," they suggest.
SOURCE: The Journal of Neuroscience 1999:19:5034-5043.
Posted by P. on August 26, 1999, at 23:03:42
In reply to what happens with long term antidepressant use?, posted by Iris on August 22, 1999, at 21:48:28
Hi,
Sorry I can't come up with the citation, but
I recall reading in the paper that depression
increases one's likelyhood of heart attacks by a
factor of 3 to 4!There was even a possible explanation given
-- something about how blood platelets use
serotonin to regulate their clotting ability,
and depressives having abnormal serotonin
handling.A library's newspaper search index could probably
find the articles. They're pretty recent; the
last few weeks or 3.Also, it's known that cortisol damages the
hippocampus, and that cortisol is high in
depression.OTOH, tricyclics can be bad on the heart, and
other drugs hard on other organs, so
it seems a bit like "choose your poison".I don't think (opinion not based on much research)
AD drugs are especially toxic, though (some have
been in use a long long time), and I'd rather
live a full short life than a longer empty one (my
opinion only).
This is the end of the thread.
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