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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Jessica on January 28, 2000, at 21:21:41
For the 3 groups of anti-depressants
THE SSRIs
THE Tricylics
THE MAOIs
Posted by Cam W. on January 29, 2000, at 10:33:48
In reply to Anyone know the long term affects of ADs, posted by Jessica on January 28, 2000, at 21:21:41
> For the 3 groups of anti-depressants
>
> THE SSRIs
> THE Tricylics
> THE MAOIsJessica - That is really a loaded question, especially when looking at all the groups. In general, most researchers have not noticed any serious long-term problems with these agents. BUT there are exceptions. These exceptions would take an immense amount of time to illustrate and most are not definitive. Some individual agents within each class can cause more problems than others. I would suggest checking in a pharmacy drug reference like Martindale's Extra Pharmacopeia or The Physicians Drug Reference (PDR) available at your local library in the reference section. On the internet you could look up studies of long-term effects for each of the drugs or classes on the PubMed or GratefulMed websites or through the National Institute of Mental Health (NIMH) website.
Good luck - Cam W.
Posted by S. Suggs on January 30, 2000, at 4:54:12
In reply to Anyone know the long term affects of ADs, posted by Jessica on January 28, 2000, at 21:21:41
> For the 3 groups of anti-depressants
>
> THE SSRIs
> THE Tricylics
> THE MAOIsGood question. Does anyone know the dangers of not taking antidepressants long term? Not trying to play games here, so do not take this question the wrong way. But, in my opinion, the benefits, in general, by far outweigh the risks. Suicide and other physical problems are eliminated (and yes, sometimes undesirable side effects). I'll agree with the other poster, it is a loaded question. Take care and many blessings,
S. Suggs
Posted by Noa on January 30, 2000, at 8:12:54
In reply to Re: Anyone know the long term affects of ADs, posted by S. Suggs on January 30, 2000, at 4:54:12
Are there any long term follow up studies being done to look at the effects of long term use of ADs?
Suggs, as for your question, that is the crux of it all for me. I don't have much choice. Not taking medications would be disastrous and I would probably be dead or homeless or in and out of the hospital.
Posted by Cam W. on January 30, 2000, at 10:30:30
In reply to Re: Anyone know the long term affects of ADs, posted by Noa on January 30, 2000, at 8:12:54
> Are there any long term follow up studies being done to look at the effects of long term use of ADs?
>
> Suggs, as for your question, that is the crux of it all for me. I don't have much choice. Not taking medications would be disastrous and I would probably be dead or homeless or in and out of the hospital.Everyone (esp. Noa) - There are a few studies I have read on the long-term effects of ADs, mostly on SSRIs (esp Prozac) during pregnancy and breastfeeding. The original "Prozac babies", the one's who were born to mothers who had taken Prozac when they were pregnant, are now around the age of 20 years. So far they have developed normally, with no more delinquency than their peers. It should be interesting to see in the next 5 - 7 years whether there is an increased prevalence of bipolar disorder or schizophrenia in this group. I feel that the studies I have read are fairly inconclusive. If there are any post-grads looking for a thesis research project, maybe they could do a formal study of people (MRIs, CT, cognitive batteries, etc.) who have taken ADs throughout the ages (eg 1950s to present) and see what they ADs have done. My personal belief is that the benefits of ADs far outweigh the risks. - Cam W.
Posted by cg on January 30, 2000, at 19:20:13
In reply to Re: Anyone know the long term affects of ADs, posted by Cam W. on January 30, 2000, at 10:30:30
Ditto. Life with depression plus antidepressants is not any walk in the park. It stinks. Life with depression minus antidepressants is NOT living at all. Wouldn't even try.
Posted by Scott L. Schofield on February 7, 2000, at 9:18:06
In reply to Re: Anyone know the long term affects of ADs, posted by cg on January 30, 2000, at 19:20:13
> Ditto. Life with depression plus antidepressants is not any walk in the park. It stinks. Life with depression minus antidepressants is NOT living at all. Wouldn't even try.
I have been on and off tricyclics antidepressants (TCAs) for quite a while without any doctor ever indicating to me that they may have any important irreversible side-effects resulting from chronic use. A recent study suggests that people using TCAs long-term may be at higher risk of having a heart-attack than those treated with an SSRI (Selective Serotonin Reuptake Inhibitor).
- Scott-----------------------------------------------------------
Tricyclic Antidepressants May Increase Risk Of Heart AttackSAN FRANCISCO, CA -- January 12, 2000 -- The type of antidepressant drug that you use may have important, long-term health implications, according to a study published today in The American Journal of Medicine.
In research conducted at the Albert Einstein College of Medicine in New York, investigators found a strong association between the use of tricyclic antidepressants - an older class of drugs that includes amitriptyline (Elavil), nortriptyline (Pamelor), imipramine (Tofranil) and desipramine (Norpramine) - and an increased risk of myocardial infarction.
However, the researchers found no increased risk associated with the use of selective serotonin reuptake inhibitors (SSRIs), a newer class of antidepressants that includes fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and fluvoxamine (Luvox).
In the study, 2247 working health plan members who received at least one prescription for an antidepressant were compared with 52,750 members who did not receive antidepressants. The patients were followed for up to 4.5 years to track hospitalization or death due to myocardial infarction. During the study period, there were 16 myocardial infarctions among the 1650 users of tricyclic antidepressants, but only two among the 655 SSRI users.
The researchers found that the risk of myocardial infarction was about two times greater in users of tricyclic agents, when compared with patients who did not use antidepressants. This risk persisted after adjusting for age, sex, baseline heart disease, diabetes, hypertension, hyperlipidemia, and anxiety. By contrast, there was no increase in the risk of myocardial infarction among patients who used SSRI's.
"We know that depression is associated with an increased risk of myocardial infarction and cardiovascular disease," said Dr. Hillel Cohen, one of the lead authors of the study. "These results raise hope that treatment with SSRIs may mitigate the cardiovascular risk associated with depressive symptoms."
In an accompanying editorial, Dr. John Barefoot of Duke University said that, while the mechanisms underlying the association between depression and an increased risk of cardiovascular disease have not been determined, the selective serotonin reuptake inhibitors might be safer than tricyclic agents, especially for patients with cardiovascular disease.
"Tricyclic antidepressants affect cardiac conduction and rhythm, and could be cardiotoxic," he says. "The Physicians' Desk Reference suggests extreme caution or close supervision when these drugs are prescribed for patients with cardiovascular disease."
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