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How Is Antidepressant Linked To Sudden Cardiac Death?
 

It is not uncommon for a person to feel depressed after a heart attack, stroke, cardiac surgery or procedure, or even new diagnosis of heart disease. This is understandable as such emotions are results of not knowing what will happen next or not being able to perform some simple tasks. For a patient to have such temporary feelings of sadness is considered normal and such feelings should gradually go away within a few weeks.

However, if depression is severe and accompanied with other symptoms (including inability to carry out normal activities, not responding to family members and visiting friends, increased negative thoughts and tearfulness) that persist everyday for 2 or more weeks and starts prevent this patient from leading a normal life, then this would definitely hinder recovery and worsen health condition. Patients belonging to this category would require treatments to help them cope and recover.

A study on antidepressant therapy in patients with ischemic heart disease published in the November 2005’s issue of American Heart Journal found that up to 15 percent of patients with cardiovascular disease and up to 20 percent of patients who underwent coronary artery bypass graft (CABG) surgery experience major depression.

On the other hand, studies have already reported that major depression could lead to development of heart disease too.

Researchers from Washington University School of Medicine and St Louis Veterans Affairs Medical Center studied 1,200 male twins who served in the United States military during the Vietnam War declared depression as an independent risk factor of heart disease. Their findings were presented at the American Psychosomatic Society meeting during March 2009.

Only twins with high genetic risk and who actually develop clinical depression were found to be at increased risk of developing heart disease. For twins with high genetic risk common to depression and heart disease but who never develop depression, there was no increased risk for heart disease.

In another study conducted by researchers from Columbia University also found new evidence on link between depression and heart disease. The researchers studied 63,469 women in the Nurses' Health Study between 1992 and 2004. At the outset of the study, these women had no sign of heart disease but nearly 8 percent of them had evidence of serious depression.

Their findings, which were published in the March 17, 2009 issue of the Journal of the American College of Cardiology, reported that depressed women were more than twice as likely to experience sudden cardiac death and they also had a slightly higher risk of death from other forms of heart disease.

To the surprise of the researchers, sudden cardiac death seemed more closely associated with use of antidepressant than with the depressive symptoms. In fact, those women prescribed with antidepressants were found to be 3 times more likely to suffer sudden cardiac death. This would mean that, according to the researchers, women who were prescribed with antidepressants were among the most seriously depressed.

The current study is certainly not the first to link the risk of sudden cardiac death to depression. It is, nevertheless, consistent with prior studies that associated depressive symptoms with a higher death rate in patients with coronary heart disease. The current study also highlighted arrhythmia as a possible cause. But the researchers pointed out that such findings should still need further study for confirmation.

So far, there is a lack of evidence to show that use of newer antidepressants would trigger a risk of irregular heartbeat, and in fact, some of these antidepressants have even offered protection. Pending further study, the researchers concluded that the benefits of appropriate use of antidepressants still likely outweigh the risk of sudden cardiac death at the present time.

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