Antidepressant and anti-anxiety medications linked to increased risk of cardiovascular events and death

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Uniformed Services University of the Health SciencesDec 15 2009

Women with suspected coronary artery disease (CAD) who report taking antidepressant and anti-anxiety medications have an increased risk of cardiovascular events, including heart attacks and strokes, and death compared to women not taking these medications, according to researchers at the Uniformed Services University of the Health Sciences (USU).

Their paper, "Psychotropic medication use and risk of adverse cardiovascular events in women with suspected coronary artery disease," reports recent findings from the Women's Ischemia Syndrome Evaluation (WISE) study. The WISE study, sponsored by the National Heart, Lung and Blood Institute of the National Institutes of Health, involves investigators at multiple study sites around the U.S., and was designed to develop methods for improved assessment and understanding of coronary artery disease in women.

According to the paper's first author David S. Krantz, Ph.D., Professor and Chairman, Department of Medical and Clinical Psychology at USU, there are several important implications of this research for women with suspected CAD. However, he also emphasized this was a correlational study and not a clinical trial, so this study's results are not definitive.

"Since depression is an important risk factor for CAD morbidity and mortality, women with suspected CAD may be inadequately treated for depression," said Dr. Krantz. "Taking these medications may be a marker of residual depression and residual depression in these women may account for increased CAD events. However, it needs to be considered that taking antidepressant and anti-anxiety medications may not be beneficial, and may in fact be harmful for some women."

Dr. Krantz also said women with suspected CAD often have unexplained chest pain, since traditional diagnostic methods for CAD -- for example, coronary angiography -- may not reveal the presence of disease.

"Many women become distressed by the undiagnosed chest pain and are prescribed these medications for this distress," said Dr. Krantz. Prior findings from the WISE study indicate women with persistent unexplained chest pain have diminished quality of life.

Because the WISE study is not a clinical trial, researchers need to be very cautious about concluding that antidepressant and anti-anxiety medications themselves are responsible for the results of the WISE study, since many factors could be associated with patients using these medications. For this reason, Krantz said, further research needs to examine whether factors such as underlying depression and anxiety, and not medications per se, may be responsible for these results. These findings also emphasize the importance of emotional and psychosocial factors in women with suspected coronary artery disease.

The paper was published in the August 6, 2009, journal, Heart.

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Uniformed Services University of the Health Sciences

Posted in: Women's Health News | Pharmaceutical News

Tags: Angiography, Antidepressant, Anxiety, Blood, Cardiology, Chest Pain, Clinical Trial, Coronary Artery Disease, Depression, Diagnostic, Heart, Lungs, Mental Health, Mortality, Nursing, Pain, Psychology, Research, X-linked

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Is DEATH acceptable?

HARVEY GROVE says:

December 17, 2009 at 10:15 PM

I am willing to accept the idea that highly trained physicians view certain situations differently than I, who is not a physician, however, there are some decisions that do not make sense to me.

Why is it that a particular drug with side effects that include DEATH is not cleared for marketing by the FDA, yet, a related compound with the same side effect profile, including DEATH, is allowed to be marketed? Is it because doctors have become inured to death so that calling it a side effect makes it OK to use? Does being a physician, who sees death on a regular basis, cause physicians to expect to see this in very few patients without feeling guilty, consequently it does not make a lasting impression in his/her thought process?

What percentage incidence of any serious side effect does a drug have to posess before a physician removes it from his/her personal formulary even though it is OK'd by FDA? When does any drug become too dangerous to consider at all? What is the percentage incidence of a serious side effect that is acceptable? Does it ever become unacceptable ? Is DEATH acceptable if it is a "side effect" but not acceptable if it is called a "TOXIC REACTION"? Has the drug industry found a way to "tone down" a toxic effect by calling it an "uncommon side effect"? Is FDA approval the only criteria a doctor cares about?

The use of drugs "OFF LABEL" means the drug has NOT YET been PROVEN "SAFE AND EFFECTIVE" to help a particular indication. Does this also mean there is not enough data to prove it is "SAFE and EFFECTIVE" as labeled (which is a requirement of FDA) because it is NOT so labeled? Has the doctor become the "MAD SCIENTIST" of fiction from the, "lets try it and see what happens?" school? WOULD THE DOCTOR USE IT ON HIS WIFE OR HIMSELF OR DOES HE HAVE A DOUBLE STANDARD?

I BELIEVE FDA HAS ALTERED IT'S STANDARDS TO PLAY INTO THE HANDS OF THE DRUG COMPANIES WHO HAVE SPENT SO MUCH INVESTIGATING A NEW COMPOUND. IF THE DRUG IS ALLOWED.... IT WILL TAKE A SHORT TIME TO RECOUP ITS INVESTMENT DEVELOPING A DRUG "THAT DID NOT MAKE THE CUT". THE DRUG COMPANIES WILL HAVE RECOUPED THEIR INITIAL EXPENSES ON THIS COMPOUND AND THE DRUG WILL BE RECALED AS WAS DONE RECENTLY WITH VITORIN. THIS SHOULD NOT BE TOO SHOCKING BECAUSE THAT IS THE NATURE OF THE BUSINESS THEY ARE IN. YOU WIN SOME AND YOU LOSE SOME. NOT ALL DRUGS UNDER INVESTIGATION EVER BECOME AVAILABLE FOR SALE, HOWEVER, THE RESEARCH EXPENSES KEEP INCREASING AND WITHOUT NEW DRUGS WHAT WILL THE COMPANIES AND FDA HAVE TO DO?

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