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Mental Health
Antidepressants: Know What You’re Getting Yourself Into
Date: 13/05/10
Keywords: Anti-Depressant, Depression, Deep venous thrombosis, Pulmonary embolism, Venous thromboembolism
A review published in 2009 in The European Journal of Psychiatry, which examined 12 observational studies, 29 case-reports and one review-article, found evidence that low potency antipsychotic drugs (antidepressants) like chlorpromazine, thioridazine, and clozapine have an increased risk of blood clots - venous thromboembolism (VTE).
I was shocked when a friend emailed me the other day with the following sad news:
“My mother was taken to hospital a few days ago and they found a large blood clot in her lung. Her doctor said it may be because she had bronchitis recently. However, my mother has been on antidepressants and I wonder if there could be a link?
Also, since I am a financial advisor – which involves advising people on life insurance policies and coverage, I find it rather uncanny that many claims against these policies are rejected because of the side effects of antidepressants. Surely, there must be something fishy about antidepressants which people don’t realise, when they blindly accept their prescriptions?”
Something Fishy
Fishy?! You bet there is! Here at the Daily Health we’ve written countless e-alerts warning people about the dangerous side effects associated with antidepressants. For example, back in 2007 we wrote about the potential risk of suicide among those treated with antidepressants and antipsychotic drugs.
Now we have this: Blood clotting in the lungs or pulmonary embolism (PE).
PE occurs when blood clots block the main artery of the lung or one of its branches. Along with deep venous thrombosis (DVT), PE is a serious illness with an annual incidence of more than 1 per 1000 persons and a mortality rate above 15 per cent in the first 3 months after diagnosis. Both DVT and PE are referred to as venous thromboembolism (VTE).
Fortunately, my friend's Mum seems to be responding well to treatment.
A review published in 2009 in The European Journal of Psychiatry, which examined 12 observational studies, 29 case-reports and one review-article, found evidence that low potency antipsychotic drugs like chlorpromazine, thioridazine, and clozapine have an increased risk of VTE.
In a French hospital-based, case–control study published in 2007, researchers from the Department of Internal Medicine and Chest Diseases at the Hôpital de la Cavale Blanche, found that exposure to antipsychotic drugs was associated with an increased risk of VTE.
The French researchers concluded that doctors should consider antipsychotic drug exposure as a potential risk factor of VTE. They also noted that more studies are needed to further clarify this adverse effect, and to determine the possible predisposing factors and the biological mechanisms involved.
In a case-control study at the Boston University School of Medicine, 782 case patients with a confirmed diagnosis of VTE who were taking an antidepressant drug were compared to 3085 matched control subjects.
The results were:
* tricyclic antidepressants (antipsychotic) were associated with a small increased risk of VTE (people with heart disease or cardiovascular problems should avoid this type of medication).
* no increased risk was found among users of selective serotonin reuptake inhibitors (SSRIs) or other antidepressant drugs
The above research indicates a possible link between VTE and the use of antipsychotic drugs, this link has not yet been established in the use of ordinary antidepressants...
Don’t throw caution to the wind
While this may be good news for those on mild antidepressants, you should be aware of the following:
I had a quick look on the website drugs.com and found a few popular antidepressants which show VTE as a possible serious side effect:
* Zyban: Zyban is an antidepressant medicine that also helps people to stop smoking by reducing cravings and other withdrawal effects. At least one brand of bupropion (Wellbutrin) is used to treat major depressive disorder and seasonal affective disorder (SAD).
* Effexor: An antidepressant in a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Effexor works by restoring hormonal imbalances in the brain, which helps to improve certain mood problems.
* Lexapro: Also an SSNRI, Lexapro affects chemical imbalances in the brain that may cause depression or anxiety. It is used to treat anxiety in adults and major depressive disorder in adults and adolescents who are at least 12 years old.
* Zyprexa: Used to treat bipolar disorder (manic depression) in adults and children who are at least 13 years old.
Making the right choice
Dealing with depression is a challenge, and antidepressants can be extremely beneficial - especially for those suffering from severe depression. Although medication may not cure your depression, it can help reduce your symptoms so that you can pursue other forms of treatment such as psychotherapy. Work closely with your doctor and explore all your options when choosing the best form of treatment for you.
* Make sure you discuss the side effects of your prescribed antidepressant. Common side effects of antidepressants include dizziness, drowsiness, constipation and blurred vision. Know which symptoms require immediate medical attention such as suicidal thoughts, worsening of symptoms, aggression, and dangerous impulses.
* In addition, make sure you ask whether the antidepressant will interact with other medications or nutritional supplements you may be taking.
Finally, going back to my friend's email, it may also be worth your while to check your life insurance policy or life cover to see if there is any fine print you might have missed. The value and validity of your cover may be affected if you are taking antidepressants.
Antidepressants: Related reading:
Laughter has Potential Medical Benefits
Depression: How to ward off depression without harmful drugs
Depression: The low-down on anti-depressants
Sources:
Deep venous thrombosis and pulmonary embolism in psychiatric settings, by Drs. Els G. Van Neste, Ward Verbruggen, Mark Leysen, published 03.2009, The European Journal of Psychiatry, scielo.isciii.es/scielo.php
Association between antipsychotic drugs, antidepressant drugs and venous thromboembolism: results from the EDITH case–control study, by Drs. K. Lacut, G. Le Gal , F. Couturaud, G. Cornily, C. Leroyer, D. Mottier, E. Oger, published 05.2007, interscience.wiley.com
Antidepressant Drug Use and Risk of Venous Thromboembolism, by Dr. Susan S. Jick, published by Pharmacotherapy 02.2008, atypon-link.com
Back to top“My mother was taken to hospital a few days ago and they found a large blood clot in her lung. Her doctor said it may be because she had bronchitis recently. However, my mother has been on antidepressants and I wonder if there could be a link?
Also, since I am a financial advisor – which involves advising people on life insurance policies and coverage, I find it rather uncanny that many claims against these policies are rejected because of the side effects of antidepressants. Surely, there must be something fishy about antidepressants which people don’t realise, when they blindly accept their prescriptions?”
Something Fishy
Fishy?! You bet there is! Here at the Daily Health we’ve written countless e-alerts warning people about the dangerous side effects associated with antidepressants. For example, back in 2007 we wrote about the potential risk of suicide among those treated with antidepressants and antipsychotic drugs.
Now we have this: Blood clotting in the lungs or pulmonary embolism (PE).
PE occurs when blood clots block the main artery of the lung or one of its branches. Along with deep venous thrombosis (DVT), PE is a serious illness with an annual incidence of more than 1 per 1000 persons and a mortality rate above 15 per cent in the first 3 months after diagnosis. Both DVT and PE are referred to as venous thromboembolism (VTE).
Fortunately, my friend's Mum seems to be responding well to treatment.
A review published in 2009 in The European Journal of Psychiatry, which examined 12 observational studies, 29 case-reports and one review-article, found evidence that low potency antipsychotic drugs like chlorpromazine, thioridazine, and clozapine have an increased risk of VTE.
In a French hospital-based, case–control study published in 2007, researchers from the Department of Internal Medicine and Chest Diseases at the Hôpital de la Cavale Blanche, found that exposure to antipsychotic drugs was associated with an increased risk of VTE.
The French researchers concluded that doctors should consider antipsychotic drug exposure as a potential risk factor of VTE. They also noted that more studies are needed to further clarify this adverse effect, and to determine the possible predisposing factors and the biological mechanisms involved.
In a case-control study at the Boston University School of Medicine, 782 case patients with a confirmed diagnosis of VTE who were taking an antidepressant drug were compared to 3085 matched control subjects.
The results were:
* tricyclic antidepressants (antipsychotic) were associated with a small increased risk of VTE (people with heart disease or cardiovascular problems should avoid this type of medication).
* no increased risk was found among users of selective serotonin reuptake inhibitors (SSRIs) or other antidepressant drugs
The above research indicates a possible link between VTE and the use of antipsychotic drugs, this link has not yet been established in the use of ordinary antidepressants...
Don’t throw caution to the wind
While this may be good news for those on mild antidepressants, you should be aware of the following:
I had a quick look on the website drugs.com and found a few popular antidepressants which show VTE as a possible serious side effect:
* Zyban: Zyban is an antidepressant medicine that also helps people to stop smoking by reducing cravings and other withdrawal effects. At least one brand of bupropion (Wellbutrin) is used to treat major depressive disorder and seasonal affective disorder (SAD).
* Effexor: An antidepressant in a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Effexor works by restoring hormonal imbalances in the brain, which helps to improve certain mood problems.
* Lexapro: Also an SSNRI, Lexapro affects chemical imbalances in the brain that may cause depression or anxiety. It is used to treat anxiety in adults and major depressive disorder in adults and adolescents who are at least 12 years old.
* Zyprexa: Used to treat bipolar disorder (manic depression) in adults and children who are at least 13 years old.
Making the right choice
Dealing with depression is a challenge, and antidepressants can be extremely beneficial - especially for those suffering from severe depression. Although medication may not cure your depression, it can help reduce your symptoms so that you can pursue other forms of treatment such as psychotherapy. Work closely with your doctor and explore all your options when choosing the best form of treatment for you.
* Make sure you discuss the side effects of your prescribed antidepressant. Common side effects of antidepressants include dizziness, drowsiness, constipation and blurred vision. Know which symptoms require immediate medical attention such as suicidal thoughts, worsening of symptoms, aggression, and dangerous impulses.
* In addition, make sure you ask whether the antidepressant will interact with other medications or nutritional supplements you may be taking.
Finally, going back to my friend's email, it may also be worth your while to check your life insurance policy or life cover to see if there is any fine print you might have missed. The value and validity of your cover may be affected if you are taking antidepressants.
Antidepressants: Related reading:
Laughter has Potential Medical Benefits
Depression: How to ward off depression without harmful drugs
Depression: The low-down on anti-depressants
Sources:
Deep venous thrombosis and pulmonary embolism in psychiatric settings, by Drs. Els G. Van Neste, Ward Verbruggen, Mark Leysen, published 03.2009, The European Journal of Psychiatry, scielo.isciii.es/scielo.php
Association between antipsychotic drugs, antidepressant drugs and venous thromboembolism: results from the EDITH case–control study, by Drs. K. Lacut, G. Le Gal , F. Couturaud, G. Cornily, C. Leroyer, D. Mottier, E. Oger, published 05.2007, interscience.wiley.com
Antidepressant Drug Use and Risk of Venous Thromboembolism, by Dr. Susan S. Jick, published by Pharmacotherapy 02.2008, atypon-link.com
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