Thursday, March 12, 2009

link between anti depressants and sudden death?

Anti depressants are very common prescribed. In fact, most folks I know are taking one of the SSRI's considered to be among the "safe medications".

That being said, Dr Joseph Glenmullen, MD in his "PROZAC BACKLASH" book stated that there is a possibility that long term use of the SSRI's can cause damage to the brain and even Parkinsonism. He should know - he's a psychiatrist and has done research as well as years of observation.

However, what did come as a bit of a surprise is a new research study which suggested that these anti depressant drugs might be linked to sudden cardiac death. The study was published in the American College of Cardiology Journal (J Am Coll Cardiol, 2009; 53:950-958, doi:10.1016/j.jacc.2008.10.060).

This was an epidemiologal study using the famous "Nurse's study data" (i.e. a "data dredge" study) so I was about to dismiss it except for when I read the last paragraph of the blog which reported the study.

The author reminded that the prescribing information from Eli Lilly for Prozac listed the following side effects:

* Frequent: hemorrhage, hypertension, palpitation
* Infrequent: angina pectoris, arrhythmia, congestive heart failure, hypotension, migraine, myocardial infarct, postural hypotension, syncope, tachycardia, vascular headache
* Rare: atrial fibrillation, bradycardia, cerebral embolism, cerebral ischemia, cerebrovascular accident, extrasystoles, heart arrest, heart block, pallor, peripheral vascular disorder, phlebitis, shock, thrombophlebitis, thrombosis, vasospasm, ventricular arrhythmia, ventricular extrasystoles, ventricular fibrillation.

That definitely changed my opinion of the research as just another "data dredge study" to a HMMMM, might be some truth in it.

How many people taking Paxil, Prozac, Zoloft et al, have seen the physician prescribing information.

Kevin Trudeau in his newest book, "More Natural Cures" has a solution which I've seen some folks follow... don't take ANY medications. But truly, there are times when medications can be a lifesaver.

The best approach may be to study things like the prescribing information and to weigh the risks vs the benefits. Since we have only one heart, perhaps the SSRI's should be a last resort rather than so often prescribed (a solution which may not be popular with those who manufacture these medications).