Posted by Scott L. Schofield on February 7, 2000, at 9:18:06
In reply to Re: Anyone know the long term affects of ADs, posted by cg on January 30, 2000, at 19:20:13
> Ditto. Life with depression plus antidepressants is not any walk in the park. It stinks. Life with depression minus antidepressants is NOT living at all. Wouldn't even try.
I have been on and off tricyclics antidepressants (TCAs) for quite a while without any doctor ever indicating to me that they may have any important irreversible side-effects resulting from chronic use. A recent study suggests that people using TCAs long-term may be at higher risk of having a heart-attack than those treated with an SSRI (Selective Serotonin Reuptake Inhibitor).
- Scott-----------------------------------------------------------
Tricyclic Antidepressants May Increase Risk Of Heart AttackSAN FRANCISCO, CA -- January 12, 2000 -- The type of antidepressant drug that you use may have important, long-term health implications, according to a study published today in The American Journal of Medicine.
In research conducted at the Albert Einstein College of Medicine in New York, investigators found a strong association between the use of tricyclic antidepressants - an older class of drugs that includes amitriptyline (Elavil), nortriptyline (Pamelor), imipramine (Tofranil) and desipramine (Norpramine) - and an increased risk of myocardial infarction.
However, the researchers found no increased risk associated with the use of selective serotonin reuptake inhibitors (SSRIs), a newer class of antidepressants that includes fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and fluvoxamine (Luvox).
In the study, 2247 working health plan members who received at least one prescription for an antidepressant were compared with 52,750 members who did not receive antidepressants. The patients were followed for up to 4.5 years to track hospitalization or death due to myocardial infarction. During the study period, there were 16 myocardial infarctions among the 1650 users of tricyclic antidepressants, but only two among the 655 SSRI users.
The researchers found that the risk of myocardial infarction was about two times greater in users of tricyclic agents, when compared with patients who did not use antidepressants. This risk persisted after adjusting for age, sex, baseline heart disease, diabetes, hypertension, hyperlipidemia, and anxiety. By contrast, there was no increase in the risk of myocardial infarction among patients who used SSRI's.
"We know that depression is associated with an increased risk of myocardial infarction and cardiovascular disease," said Dr. Hillel Cohen, one of the lead authors of the study. "These results raise hope that treatment with SSRIs may mitigate the cardiovascular risk associated with depressive symptoms."
In an accompanying editorial, Dr. John Barefoot of Duke University said that, while the mechanisms underlying the association between depression and an increased risk of cardiovascular disease have not been determined, the selective serotonin reuptake inhibitors might be safer than tricyclic agents, especially for patients with cardiovascular disease.
"Tricyclic antidepressants affect cardiac conduction and rhythm, and could be cardiotoxic," he says. "The Physicians' Desk Reference suggests extreme caution or close supervision when these drugs are prescribed for patients with cardiovascular disease."
poster:Scott L. Schofield
thread:19940
URL: http://www.dr-bob.org/babble/20000128/msgs/20683.html