View Full Version : Antidepressants Linked to Stroke/ Death

12-23-09, 06:03 PM
In Postmenopausal Women:

Antidepressants Linked to Increased Risk for Death, Stroke in Postmenopausal Women

December 22, 2009 — Postmenopausal women taking either a tricyclic antidepressant (TCA) or a selective serotonin-reuptake inhibitor (SSRI) appear to be at increased risk for all-cause mortality, and SSRIs users seem to be at increased risk for hemorrhagic and fatal stroke, although the absolute event risks are low, according to an analysis from the Women's Health Initiative (WHI) study.

In an article published in the December issue of the Archives of Internal Medicine, Jordan Smoller, MD, from Massachusetts General Hospital, Boston, and colleagues report that new use of either a TCA or an SSRI during a mean follow-up of 5.9 years was not significantly associated with an increased risk for coronary heart disease (CHD) in this large prospective cohort of postmenopausal women.

In contrast, compared with women who did not use antidepressants, "those using SSRIs had a 45% increased relative risk of incidence stroke and a 32% increased risk of death in models stratified on propensity and adjusted for multiple covariates," the investigators report. TCA use in turn was associated with a 67% higher relative risk for all-cause death (hazard ratio [HR], 1.67; 95% confidence interval [CI], 1.33 - 2.09). The TCAs also increase stroke risk, but not significantly so.

"Depression is still a much more established risk factor for cardiovascular disease (CVD) than antidepressants, so it's not as though not taking an antidepressant removes the risk because then you have untreated depression, which itself is risky," Dr. Smoller told Medscape Psychiatry. "But if a woman is concerned about taking medication, there are alternative treatments for depression, such as cognitive behavioral therapy, which can be effective."

Association Explored

For the analysis, investigators examined the association between new antidepressant use and first occurrence of CHD, fatal or nonfatal stroke, and all-cause mortality occurring after the first follow-up visit.

The first follow-up visit for women enrolled in the longitudinal cohort observational study was at 3 years; for women enrolled in 1 of the 3 overlapping clinical trials it took place at 1 year after baseline.

A total of 136,293 postmenopausal women were involved in the WHI, and women taking no antidepressants at study entry and who had at least 1 follow-up visit were included in the analysis.

During the follow-up interval, 5496 women initiated antidepressant treatment. Antidepressant users had higher levels of several CVD risk factors than nonusers. To address potential confounders, investigators obtained a propensity score from a logistic regression model.

Annualized rates per 1000 person-years of stroke with no antidepressant use were 2.99 vs 4.16 for SSRI users. Death rates for non–antidepressant users were 7.79 per 1000 person-years and 12.77 for SSRI users. Annualized mortality rates for TCA users were 14.14 deaths per 1000 person-years.

As investigators point out, the excess risk for stroke seen in association with SSRIs was largely hemorrhagic (HR, 2.12; 95% CI, 1.10 - 4.07), whereas the risk for ischemic stroke with SSRI use did not reach statistical significance (HR, 1.21; 95% CI, 0.80 - 1.83).

In contrast, both the SSRIs and the TCAs were associated with an increased risk for all fatal strokes (HR, 2.10; 95% CI, 1.15 - 3.81; and HR, 2.56; 95% CI, 1.26 - 5.26, respectively).

A key question is whether the association between antidepressant use and CV morbidity and mortality is truly related to drug exposure or to underlying differences in other CV risk factors, including depression.

As Dr. Smoller explained to Medscape Psychiatry, the propensity score used in this study did help control for risk factors that could have explained differences in CV outcomes between antidepressant users and nonusers, "but you can't fully tease out the effect that depression itself and some of these risk factors may have had vs the contribution of the medication."

He continued, "If you look at the annualized death rates in all cohorts, the absolute differences [between AD users and nonusers] is very small, so our findings have to be weighed against the risk of CV disease and mortality associated with untreated depression vs antidepressant use because we know it can have a dramatic effect on the ability of patients to enjoy life."

In an invited commentary, Christopher O'Connor, MD, and Mona Fiuzat, PharmD, from Duke University Medical Center, Durham, North Carolina, agreed that the most difficult aspect of these trials is that patients who are likely to be treated with antidepressants have additional risk factors for mortality and CV risk that are difficult to control for.

They also point out that the study cannot fully address situations in which patients begin treatment with antidepressants but do not respond to treatment, and that these patients may represent the highest-risk mortality group.

Nevertheless they indicate that the findings — in the largest cohort of women yet studied — provide "additional warning" that antidepressant use does have certain negative consequences in this particular demographic and that its risks should be considered against the potential benefits of treating depression.

The WHI program is funded by the National Heart, Lung, and Blood Institute. Dr. Smoller has served as a consultant for Eli Lilly and received honoraria from Hoffman-La Roche Inc, Enterprise Analysis Corporation and MPM Capital. He has also served on an advisory board for Roche Diagnostic Corporation. Dr. O'Connor has disclosed no relevant financial relationships.

Arch Intern Med. 2009;169: 2128-213;2140-2141. Abstract Abstract


12-23-09, 07:48 PM
That is frightening-and these drugs get passed out like candy.

12-23-09, 08:27 PM
Being fluoride-based is my new bandwagon, & many of the SSRIs are. And docs don't realize that & the PDR doesn't warn about it.

12-24-09, 01:46 PM
Being fluoride-based is my new bandwagon, & many of the SSRIs are. And docs don't realize that & the PDR doesn't warn about it.

Why woulkd fluoride be added to an SSRI (or anything else)? I don't understand the rationale.

12-25-09, 09:02 PM
Why would fluoride be added to an SSRI (or anything else)? I don't understand the rationale.

Sirona Biochem Starts Testing First Batch Of Drug Candidates Designed To Combat Diabetes And Obesity

Sirona Biochem Corp. (TSX-V: SBM), an emerging biotech company focused on diabetes and obesity, announced today that it has now taken delivery of its first batch of unique SGLT compounds from its French partner TFChem (Rouen, France) for screening and evaluation.

"The successful production of these new molecules marks a significant company milestone," said CEO, Dr. Howard Verrico.

Sirona Biochem owns the worldwide product rights to a library of sodium glucose transporter (SGLT) inhibitors to treat diabetes and obesity. SGLT Inhibitors block the reuptake of excess sugars from urine in the kidney which can then reduce high blood sugar to normal levels.

It's estimated that there are nearly 21 million people in the United States, or 7% of the population, who are diabetic. About 15 million have been diagnosed with the disease, but over 6 million people are unaware that they are suffering from it. It is forecast that by 2025, 333 million people will have diabetes.

Management of sugar metabolism is a primary medical challenge associated with treating diabetes and obesity . . .
. . . TFChem, of Rouen, France, is a drug-discovery company which uses fluorine atom properties to develop new glycomimetic compounds: the GlycoMim® technology. TFChem is a leader in the area of fluorinated glycosides and their application as new, more potent and safer drugs. Through application of the patented core technology it is the intention to modify and discover new carbohydrate based drug compounds with increased therapeutic properties and clinical improvement potential.

Article Date: 30 Jul 2009 (http://www.medicalnewstoday.com/articles/159343.php)


Index of Fluoride-based medications. (http://www.slweb.org/ftrcfluorinatedpharm.html)

The medical community is still recommending fluoride: Drugs.com (http://www.drugs.com/mtm/fluoride.html)

This PDF (http://www.hawkeshealth.net/community/www.earthclinic.com/FLUORIDE_QA.pdf) gives info related to chronic fluoride poisoning & its relationship to thyroid dysfunction & fibromyalgia (the following is a small quote from the PDF):

"It has been proposed here that many chronic Pain-Fatigue Syndromes (including CFS, FMS, and PGS) are caused by magnesium deficiency plus concomitant fluoride excess (MDFE), and that these chronic illnesses present a major and growing worldwide public health concern due to decreasing intake of Mg and ever-increasing levels of exposure to fluoride compounds used in industry, agriculture, medicine, and household and personal hygiene products. “

Julia A. Laylander
Journal of Chronic Fatigue Syndrome, 1999

In "stage 1" of chronic fluoride poisoning this article lists the following effects:

Thyroid Dysfunction
Immune System Dysfunction
Chronic Fatigue (CFS)
Neck Stiffness

Guess what the docs give folks to combat this? Fluoride-based meds including anti-depressants. And, in my own personal experience, most of these doctors don't even realize these meds are fluoride-based, nor the problems that they can compound on top of being chronically fluoride poisoned. And the PDR, their bible on drugs & side effects, usually doesn't warn of these problems or even state that there might be issues. The docs would have to be much more astute in chemistry to understand this.

Fluoride is one of the most toxic elements around.

The 1984 issue of Clinical Toxicology of Commercial Products lists fluoride as more poisonous than lead and just slightly less poisonous than arsenic. It has been used as a pesticide for mice, rats and other small pests.

Wholy Water (http://www.wholywater.com/fluoride.html)

No, i can't imagine that there is any good reason to have medications fluoride-based, but there are a number of them out there (i read the figure of 20-25% of meds are fluoride-based).

12-26-09, 01:25 AM
Thanks, Katee! If you come across more fluroide/drug information, would you post it for us?

12-26-09, 11:14 AM
The Growing Popularity of Fluorinated Pharmaceuticals

Interestingly, organic fluorinated compounds are rarely found in nature, and the few that do exist are highly toxic. Why, then, are fluorinated compounds so commonly used in the pharmaceutical industry? There are several reasons for the now widespread use of fluorinated pharmaceuticals.

The first important factor is that organic fluorinated compounds are inherently bioactive.

Second, introducing fluorine into a bioactive compound that does not already contain it improves the pharmacological properties of that compound in many cases. Simply by adding fluorine, many drugs can be made more potent, meaning that a lower dose may be used to achieve the same effect.

Third, the addition of fluorine to bioactive compounds does not usually change their shape to any great degree. This is a crucial factor in the pharmaceutical industry, because changing the shape of a bioactive compound may decrease its potency, or completely inhibit its bioactivity.

The fourth important feature of fluorinated pharmaceuticals is that the addition of fluorine increases the stability of these products, due to the strong covalent bond formed between fluorine and carbon. However, it should be noted that this is sometimes a drawback, as this increased stability can reduce the metabolic degradation rate of some fluorinated pharmaceuticals.

Finally, the increasing ease of use of fluorinated compounds is also noteworthy. In its elemental form, fluorine is a highly reactive and toxic gas, which has limited its use to specially-equipped laboratories in the past. However, in recent years specialized equipment for generating and handling fluorine has become more widely available.

As the use of fluorine has become more mainstream, its range of potential applications has increased dramatically. For example in many cases, fluorine may be able to be substituted in currently known chlorinated or brominated pharmaceuticals with relative ease, potentially increasing their potency.


12-26-09, 11:19 AM
I also just want to add that Fluorine and Bromine are close to Iodine on the atomic table and belong to a family of compounds called halogens. Iodine is the primary molecule of the thyroid hormones. Both Bromine and Fluorine are more active than Iodine and readily displace Iodine in thyroid hormones. The fluoridation of water, addition of Fluorine to meds etc along with the bromination of flours and other processed foods is responsible for a large portion of the hypothyroid epidemic.

Rather than admit there is a problem, all the governments do is continually lower the upper rance of "normal" on tests and leave millions (mostly women) suffering. For example; 60 years ago Free T3 "normal" topped at around 620. Values today generally top out at 420. I've seen some as low as 380. T3 is the active thyroid hormone. I'm sorry TMI, but lack of thyroid treatment and false lab tests are part of my bandwagon, lol.

12-26-09, 11:58 AM
Thank you, Mellowsong. Better TMI than not enough.

12-27-09, 12:08 AM
Thanks, Mellowsong. I have been interested, as well, in the interaction of the halogen elements, especially including the thyroid link. This is information that we seldom hear enough about.

12-27-09, 01:34 AM
I agree-this is the type of information that has profound impact on our health (I have thyroid problems) and just being aware to check will help.
Thank you Katee and Mellowsong-please continue to pass this on!

Hawke's Health Members ROCK!!