Menopausal Women on Antidepressant Have Increased Risk of a Stroke

A recent study by researchers from the Albert Einstein College of Medicine was recently published in the Archives of Internal Medicine and sounds a warning for menopausal women who are subject to depression.

Depression is already a known risk factor for cardiovascular disease but it seems that taking antidepressants may significantly increase the risk of stroke for women who are post menopause. The study is based on data from the well respected Women’s Health Initiative which was responsible for proving that hormone replacement therapy significantly increased the risk of heart attack, stroke, cancer and death in postmenopausal women.

This was a long term six year study of over 136,000 women between the ages of 50 and 79. They found that those taking antidepressants were 45 percent more likely to suffer from a stroke in that time than women not taking the drugs, and 32 percent more likely to die from any cause. The risk of stroke for a postmenopausal woman taking an antidepressant was roughly one in 200 in each given year and the increased stroke risk from antidepressants remained the same regardless of which drug class women were taking, whether they were selective serotonin reuptake inhibitors (SSRIs) or tricyclics. However SSRIs appeared to pose a higher risk for a hemorrhagic stroke caused by brain bleeding.

The Stroke Association are currently funding further studies to look into the links between depression and the risk of stroke. If you want to reduce your own risk then simple measures to take are to make lifestyle changes such as reducing your blood pressure, giving up smoking, reducing alcohol intake, improving your diet and getting plenty of exercise.

Antidepressants Can Affect Breast Feeding

If a woman is planning on breast feeding, and has been having treatment for anxiety or depression that involves taking selective serotonin reuptake inhibitor (SSRI) drugs may find that it delays their ability to produce breast milk after their baby is born.

This study at the University of Cincinnati was just reported in the Journal of Clinical Endocrinology and Metabolism and its findings are significant.  Although this is only a small study, 87.5% of women on SSRI drugs had delayed milk delivery compared to 43.5% of those not taking the drugs.   Delayed milk production is an early breastfeeding difficulty faced by many women, particularly those who are first term time mothers, and defined as being over 72 hours after giving birth.  This difficulty also contributes to the mother ceasing to breastfeed before the recommended time. These women also are at risk of early cessation of breastfeeding.

SSRI drugs are the most commonly prescribed class of antidepressants and are typically used to treat ‘baby blues’ depression.  A more natural solution would be to turn to natural medicine such as St John’s Wort, or more particularly natural progesterone as that is the hormone that drops most dramatically after giving birth and the one that could most help elevate mood without any ill effects for the baby.

Health Bite:

Smoking in Pregnancy can Permanently Affect a Baby’s Blood Pressure

A Swedish study has shown that babies born to women who smoked during pregnancy show evidence of persistent problems in blood pressure regulation that start at birth and get worse throughout their first year.

The study was reported in the journal of the American Heart Association and raises serious concerns that the seeds being sown in pregnancy will reap a lifetime of ill health for the baby. Normally, when a person stands, the heart rate increases and the blood vessels constrict to keep blood flow to the heart and brain and so there is a standard repositioning test to see how a baby’s blood pressure responds to tilting them upright during sleep. The results were dramatically different in those born to mothers who smoked during pregnancy compared to those who did not.

The non-smoking mothers (on average 15 cigarettes a day) saw only a 2% increase in blood pressure in their babies when they were tilted upright at one week of age and later a 10 percent increase in blood pressure at one year. But, the babies of smoking mothers saw the exact opposite with a 10% increase in blood pressure during a tilt at one week and only a 4 percent increase at one year. At three months and one year, the heart rate response to tilting in the tobacco-exposed infants was abnormal and highly exaggerated, researchers reported.

The concern obviously is that early life exposure to tobacco can lead to long-lasting reprogramming of the baby’s blood pressure control mechanisms. The researchers found that such babies have a hyper-reactive system in the first weeks of life because the blood pressure increases too much when they are tilted up, but at one year they under-react and are less effective in adapting to an upright position. Despite any amount of health warnings some mothers still do smoke, and one argument I have heard is that it is better to smoke as it reduces the mother’s stress levels. A stressed mother is certainly not good for the baby, but this research shows the long-term implications are even more serious if she continues to smoke – or those around her do.

Natural stress beaters

When I was writing my book ‘How to Cope Successfully with Stress’, it was actually a stressful process in itself to meet the publisher’s deadline and so I put together a ‘stress kit’ for myself. I thought you might also find it useful, so here is what I used:

First of all a really good multivitamin to fill nutritional gaps and counteract the negative effects of unhealthy stress on the body and a separate B-complex as it helps balance mood and calm the nervous system. I have already mentioned the benefits of Omega-3 and a deficiency here is associated with increased anxiety and depression.

Stress can often prevent you getting off to sleep, and the herb Valerian is helpful here due to the essential oils that the root contains. Again to help you sleep, you need calcium and magnesium as they are involved in calming those thoughts running round your head, can relax your muscles and so help you sleep better.

Finally, a natural alternative to antidepressants in keeping your mood stable is St. John’s Wort as it helps boost mood and maintain a healthy emotional outlook.

Antidepressant drug statistics turn out to be depressing

My views on antidepressants are that they be necessary for some people, at some time, but that natural methods and therapy work just as well. Now it seems, I have support from Stephen Wisniewski, a professor at the University of Pittsburgh, who set up a study of data compiled in a massive, government-funded review of more than 40 psychiatric facilities. Known as the ‘Sequenced Treatment Alternatives to Relieve Depression’, it’s catchy title reveals that antidepressants are only effective in a small percentage of patients and then only within a very narrow spectrum of conditions.However, most patients have multiple issues and it appears the majority (around 60 percent) are not benefiting from being given antidepressants. What is as troubling is the fact that the ‘great results’ given out by the pharmaceutical companies have been carefully selected so that patients in their particular drug’s trial are only those within the spectrum that the drug can help – in other words it seems they exclude the multiple issue patients. When Wisniewski did a comparison of patients in drug trials, against those whose data was in the Sequenced Treatment research it appeared that only 22 percent of the people he studied would have been eligible for the drug trial. Hardly a representative sample of the general population who suffer from depression.

Depression can be debilitating and destructive and I am all in favour of doing what works, but a preliminary step of seeking help from counselling, hypnotherapy, cognitive behaviour and herbs such as Rhodiola and St John’s Wort would seem like a good first step.

Alert – The placebo effect and antidepressants

Five centuries ago, the Swiss alchemist and physician Paracelsus (1493-1541) wrote: “You must know that the will is a powerful adjuvant of medicine.” In a nutshell that sums up the effect that placebos can have on our bodies: they can effect change without containing any active chemical ingredients that could medically make a difference to the state of our health, and yet they often can provoke therapeutic effects – both positively and negatively – when administered to patients.

Researchers now believe that belief in the placebo as being part of a curative treatment seems to stimulate the body’s own healing mechanism – if we believe it is doing us good, then it is. Our belief stimulates certain bio-chemical responses and reactions and increases our ability to initiate our own healing process.

The term placebo literally means “I shall please” and was used in mediaeval prayer in the context of the phrase Placebo Domino (“I shall please the Lord”). Much later, during the 18th century, the term was adopted by medicine and was used to imply preparations of no therapeutic value that were administered to patients as “decoy drugs.” Over time it became recognised as having an important role in the therapeutic treatment of patients and in more recent studies, the placebo effect was estimated at 60% of the overall therapeutic outcome. In a recent review of 39 studies regarding the effectiveness of antidepressant drugs, psychologist Guy Sapirstein concluded that 50 per cent of the therapeutic benefits came from the placebo effect, with a poor percentage of 27% attributed to drug intervention. Now an even more startling study by the FDA has revealed that the new generation of SSRI anti-depressant drugs are even less effective than Sapristein’s study showed.

I have a vested interest in the subject as I have been treated for depression since my teens and now 50 years on have tried many drugs, therapies and natural alternatives and finally discovered that I just have to learn to recognise it and live with it as for me nothing has proved effective over the long term and the side effects of antidepressants have seriously affected both my creativity and natural personality. Depression is a serious medical illness caused by imbalances in the brain chemicals that regulate mood. I am certainly not alone with my experience of depression as it affects one in six people at some time during their life, making them feel hopeless, worthless, unmotivated, even suicidal.

Doctors measure the severity of depression using the “Hamilton Rating Scale of Depression” (HRSD), a 17-21 item questionnaire. The answers to each question are given a score and a total score for the questionnaire of more than 18 indicates severe depression.

Mild depression is often treated with psychotherapy or cognitive-behavioural therapy to help people to change negative ways of thinking and behaving. For more severe depression, current treatment is usually a combination of psychotherapy and an antidepressant drug, which is used to normalize the brain chemicals that affect mood.

Antidepressants include “tricyclics,” “monoamine oxidases,” and “selective serotonin reuptake inhibitors” (SSRIs). SSRIs are the newest class of antidepressants and the FDA (Food and Drug Administration) in the USA has reported on both published and unpublished trials on SSRIs submitted to them during their licensing process. The findings have rocked the medical world as it has indicated that these drugs have only a marginal clinical benefit. On average, the SSRIs improved the HRSD score of patients by just 1.8 points more than the placebo. The most effective clinical rating for SSRI’s was for severely depressed patients and the FDA again reported that this reflected a decreased responsiveness to placebo rather than an increased responsiveness to antidepressants. I am not saying don’t take antidepressants, I have done so myself, but I am saying think before you go down the drug intervention route.

That ‘will’ that Paracelsus referred to that certainly has a powerful role to play, particularly in the area of whether we regard our treatment positively or negatively, regardless of what it contains. Positive or negative thinking seems to be a decisive risk factor for every treatment, perhaps even more important than medical intervention, so looking at our attitude to life could be the first place to start. Research clearly indicates that positive thinkers live on average 6 years longer than those who always respond negatively to life – it’s not about being a ‘Pollyanna’ and forever looking on the bright side but it is about taking those lemons life hands out and making some lemonade, or in my case lemon curd, rather than leaving them in the bowl to rot and decay.