A recent study that points to a possible link between the use of antidepressants and a higher risk of stroke and death in postmenopausal women illustrates the importance of reading beyond the headlines when it comes to medical news.
The study, published in the Archives of Internal Medicine, followed more than 130,000 postmenopausal women for an average of about 6 years. When they entered the study, the women weren't taking antidepressants although some of the women (almost 5500) reported new usage at follow up visits.
Taking a selective serotonin reuptake inhibitor (SSRI) - a common class of antidepressant that includes fluoxetine (Prozac) and sertraline (Zoloft) - was associated with a 45-percent higher risk of stroke and a 32-percent higher risk of death from any cause. Taking another, older kind of antidepressant from a class known as tricyclic antidepressants - examples include imipramine (Tofranil) and amitriptyline (Elavil) - was associated with a 67-percent higher risk of death from any cause.
Given that strokes (and death) become more common with age, postmenopausal women already have a reason to be concerned about their risk. And given the high number of Americans taking antidepressants, this news could affect a lot of people. But does this new finding mean that women on antidepressants should stop taking their medication and hope for the best? Not at all. Here's why.
First, just because your risk of a problem goes up doesn't mean you're in immediate or critical danger... or that it is even likely to happen to you at all. (For example, even if your risk of being struck by lightning or getting bitten by a shark doubled, these would still be unlikely occurrences). In the case of this research, while a postmenopausal woman not taking an antidepressant has about a 0.3 percent chance of having a stroke during any given year, that chance merely rises to 0.4 percent if she's taking an SSRI. So the risk is worth thinking about, but not necessarily a reason to make a change.
Secondly, depression itself bumps up your risk for a lot of conditions. Depression has been linked to higher risk of coronary heart disease and type 2 diabetes. It's also been associated with a higher risk of stroke and a greater likelihood of dying after a stroke.
The authors put some effort into trying to figure out if the women's risk was linked to their antidepressants or their underlying depression. In the end, they couldn't entirely rule out that the depression could be influencing these results.
Whether you're a postmenopausal woman taking antidepressants or not, an older man, or anyone worried about your stroke risk, this research does serve as a reminder that you can be taking steps to substantially lower your risk. If you smoke, stop. If your blood pressure is too high, take the steps necessary - like weight loss, dietary changes, and medication if needed - to lower it. If your cholesterol is too high, try to reduce your numbers to optimal levels with exercise, diet, and medication if need be. Doing these things can likely help counteract whatever stroke risk an antidepressant may pose, and more.