SSRIs: Are They Worth the Risk?

Bellingham, WAWomen who take antidepressants may know that potential SSRI side effects including an increased risk of Persistent Pulmonary Hypertension of the Newborn (PPHN). A new study conducted in the US also suggests that antidepressants may not be useful for treating depression, while British studies suggest an increased risk of stroke and fracture for people who use antidepressants.

In the first study, a review of FDA trials suggests that antidepressants are not much better than placebos at treating antidepressants. The study, published in the August issue of Psychotherapy and Psychosomatics, analyzed four meta-analyses of trials submitted to the FDA and included analysis of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial.

According to Medscape on 8/24/10, researchers found that of the 4041 patients who were started on citalopram (Celexa), 108 patients had remission without a relapse or had remission and dropped out by the end of the continuing care. That means that only 2.7 percent of patients who took citalopram in the studies analyzed experienced sustained benefit from taking the medication.

Researchers, however, noted that there are some people for whom antidepressants are beneficial.

Meanwhile, two studies have shown an increased risk of stroke, falls and fractures in patients who take antidepressants compared with people who do not use antidepressants. One study, cited online at pulsetoday.co.uk on 8/03/10, found that patients who take SSRIs have a significantly increased risk of stroke. The highest risk was seen with venlafaxine (Effexor, an SNRI), which had an increased risk of 51 percent over patients who do not use an antidepressant.

A second study found patients who took venlafaxine had a 68 percent higher risk of falls and an 87 percent higher risk of fractures. Patients who took citalopram had a 76 percent higher risk of falls and a 62 percent higher risk of fractures.

Women who are pregnant and taking SSRIs may run a higher risk of giving birth to infants with birth defects such as PPHN. Based on these latest studies, women who are pregnant or thinking of becoming pregnant and are taking an SSRI may want to discuss their options with their doctor. Antidepressants should not be discontinued without first discussing the benefits and negatives with a doctor.