Postmenopausal Women on Antidepressants Have an Increased Risk for Death/Stroke.

If you’re a postmenopausal woman and are taking selective serotonin-reuptake inhibitors (SSRI) or tricyclic antidepressants (TCA), research shows you seem to be at an increased risk for all-cause mortality. The SSRI women are also at risk for hemorrhagic and fatal strokes according to the Women’s Health Initiative Study.

This is not good considering the millions of women on a SSRI or TCA medication.

To be more specific, women using SSRI’s had a 45% increased risk of stroke and 32% risk of death. Those who use TCA’s had a 67% higher relative risk for death but not significantly increased stroke risk.

The analysis is quick to point out that depression itself is also a risk factor for cardiovascular disease and women should not suddenly stop their antidepressant medication but instead, talk with their healthcare provider about possible alternatives.

As a naturopathic doctor, I recommend reducing your cardiovascular risk factors in other areas such as keeping cholesterol healthy, lower blood sugar, increase exercise, stop smoking, increase fruit/vegetables/fiber, reduce alcohol and take enough fish oil.

Additionally, there are other options that impact depression. The study recommends cognitive behavioral therapies to help women, who have yet to start medication, avoid it all together. I commonly check hormones levels including estrogen, progesterone, testosterone, DHEA, thyroid and adrenal function. Additionally I utilize neurotransmitter testing to give me an idea of the serotonin, epinephrine, norepinephrine, and dopamine in the body.

There are several natural treatments that some women find effective with depression. Vitamin D greatly helps seasonal affective disorder. Options such as St. John’s wort, SAMe, 5-HTP, B-complex vitamins, folic acid and light therapy (using a light box) have been shown beneficial. Helpful herbs include lavender, chamomile, passionflower, skullcap and lemonbalm.

Naturally, before starting any supplements or herbal supplements, talk with a healthcare provider that knows how to manage your treatment.

Reference:
Smoller J. Arch Intern Med. 2009;169:2128-2139; 2140-2141.