Furious Seasons

December 14, 2009

Study: Anti-Depressants Linked To Increased Stroke Risk In Older Women

A new study just out in the Archives of Internal Medicine delivers more bad news for anti-depressants and their defenders. The study was part of the Women's Health Initiative and looked at 136,293 post-menopausal women.

"Results: Antidepressant use was not associated with coronary heart disease (CHD). Selective serotonin reuptake inhibitor (SSRI) use was associated with increased stroke risk (hazard ratio [HR],1.45, [95% CI, 1.08-1.97]) and all-cause mortality (HR,1.32 [95% CI, 1.10-1.59]). Annualized rates per 1000 person-years of stroke with no antidepressant use and SSRI use were 2.99 and 4.16, respectively, and death rates were 7.79 and 12.77. Tricyclic antidepressant (TCA) use was associated with increased risk of all-cause mortality (HR,1.67 [95% CI, 1.33-2.09]; annualized rate, 14.14 deaths per 1000 person-years). There were no significant differences between SSRI and TCA use in risk of any outcomes. In analyses by stroke type, SSRI use was associated with incident hemorrhagic stroke (HR, 2.12 [95% CI, 1.10-4.07]) and fatal stroke (HR, 2.10 [95% CI, 1.15-3.81]).
"Conclusions: In postmenopausal women, there were no significant differences between SSRI and TCA use in risk of CHD, stroke, or mortality. Antidepressants were not associated with risk of CHD. Tricyclic antidepressants and SSRIs may be associated with increased risk of mortality, and SSRIs with increased risk of hemorrhagic and fatal stroke, although absolute event risks are low. These findings must be weighed against quality of life and established risks of cardiovascular disease and mortality associated with untreated depression."

Researchers were quick to tell the press that the study meant next to nothing.

"'[S]tatistical significance can be different from clinical significance,' stressed Dr. Jordan W. Smoller, an associate professor of psychiatry at Harvard Medical School, and lead author of a report in the Dec. 14 issue of Archives of Internal Medicine. 'It is possible that a statistically detectable effect may not be a problem for most people.'"

Um, call me crazy, but a 45 percent increase in stroke risk associated with SSRI use strikes me as significant as does all the other negative findings around anti-depressants and women's health and fetal health in recent years.

Posted by Philip Dawdy at December 14, 2009 02:32 PM

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Comments

Good God man, n=5496. The statistical power is so high that even tiny differences will test as significant.

So the comment on "statistical significance" versus "clinical significance" is a valid one.

SSRI's do decrease the storage of 5-hydroxytryptamine in platelets, so the association with hemorrhagic stroke is at least plausible.

Posted by: Blackeneth at December 14, 2009 09:30 PM

I will not read it.
I am aware that this effect is possible and I don't want to thin about it.
My family has a long history of hear attacks and strokes...

Posted by: Ana at December 15, 2009 12:22 PM

Don't you just love how they do these studies and anytime they come out bad, they find a way to discount the results?

Why don't they quit designing these bogus studies that render results that can be written off as insignificant?

What's the point in doing them at all?

Posted by: Evelyn Pringle at December 15, 2009 03:52 PM

"Background Antidepressants are commonly prescribed medications, but their effect on cardiovascular morbidity and mortality remains unclear."

I hope women are savvy shoppers/consumers because as a major marketing target they should be; and considering the above statement, they should take a walk, kick someone's ass and keep going off meds.

Posted by: Stephany at December 15, 2009 05:54 PM