dangerous side effect of certain antidepressants

How Antidepressants May Hurt Your ArteriesA number of weeks ago, I told you about a surprising and dangerous side effect of certain antidepressants -- they can mess up your heart’s rhythm (see the December 1, 2011 issue of Daily Health News). Today, I need to warn you about another little-known way that antidepressants may hurt your cardiovascular system -- they may thicken your artery walls. Few studies to date have examined this phenomenon, yet it poses a serious health risk. Narrowed arteries raise your risk for heart attack and stroke. Anyone taking an antidepressant should have this information. At Emory University School of Medicine in Atlanta, cardiologist Amit J. Shah, MD, and his colleagues decided to study this topic because the potential connection between antidepressant use and heart disease has been poorly understood. He presented his preliminary findings at the annual meeting of the American College of Cardiology this past spring in New Orleans. I gave him a call to get more details. one thickening, sickening problem To rule out genetics as a factor, Dr. Shah and his colleagues analyzed people from one of the largest twin databases in the country -- 513 pairs of identical and fraternal male twins (average age 55). At the time of the research, about 16% of the men were taking antidepressants -- all different kinds, though 60% of the antidepressants were selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), duloxetine (Cymbalta) and sertraline (Zoloft). The researchers didn’t record how long the men had been taking the medications or the exact dosages. They used ultrasound to take one measurement of the thickness of the linings of the mens’ carotid arteries (the main arteries in the neck that supply blood to the brain). What the study found: As we grow older, our arteries naturally thicken at the rate of about 10 microns (one millionth of a meter) per year, but Dr. Shah discovered that participants who had been taking any type of antidepressant had experienced substantially greater artery thickening. When the researchers looked at the 59 twin pairs in which one twin was taking an antidepressant and the other wasn’t, the carotid artery lining was, on average, about 40 microns (about 5%) thicker in the twin taking the drug. The men were not followed to see who developed cardiovascular disease and who didn’t, but previous research has revealed that each 10-micron increase in carotid artery thickness is associated with a 1.8% increase in risk for cardiovascular disease, so that 40-micron increase in thickness could correlate to about a 7.2% increased risk for cardiovascular disease in the men who were on antidepressants. Another way to look at it: Their arteries were, in effect, four years older than their brothers’ arteries, noted Dr. Shah. This finding took into consideration other factors that can affect artery thickness, including alcohol and coffee intake, previous history of heart disease, history of post-traumatic stress disorder and depression. "A higher level of depressive symptoms was associated with higher artery thickness only in those taking antidepressants," said Dr. Shah. "Therefore, antidepressants may act synergistically with depressive symptoms to increase risk for artery thickness." WHY THE DISHEARTENING EFFECT?Dr. Shah theorized why the antidepressants might have been associated with having thicker arteries. Antidepressants, of course, work by increasing levels of neurotransmitters. Yet while these chemicals act in your brain to relieve symptoms of depression, Dr. Shah said that they also may cause blood vessels elsewhere in the body to constrict or tighten, which can lead to thicker arteries. Dr. Shah cautioned that this is an observational study -- not a test of cause-and-effect -- so we can’t definitively conclude from it that antidepressants cause artery thickening. Further research is needed to confirm these results. WEIGH THE PROS AND CONS So if you’re on an antidepressant, what should you do? "No one taking antidepressants should stop taking them based solely on the results of this study," said Dr. Shah. That is undoubtedly true. But keep in mind that, like all drugs, antidepressants have side effects -- some that we can see and feel (e.g., agitation, insomnia, sexual dysfunction) and perhaps others that we cannot. And if you’re considering taking an antidepressant, consider natural treatment first, such as exercise, healthy eating and talk therapy. Sit down with your doctor and carefully discuss the pros and cons for your particular situation. Source: Amit J. Shah, MD, cardiology fellow, Emory University School of Medicine, Atlanta.