Back to News

By Herb Newborg

Antidepressants Increase Stroke Risk By 45%, Usage Has Skyrocketed
Middle-aged women who take antidepressants are at an increased risk of stroke, a major study has found.

A large study of women who have been through menopause found those taking antidepressants were 45 per cent more likely to suffer a stroke than those of the same age not on the medicines.

The research also found that overall death rates were 32 per cent higher in women on the drugs.

The findings are from an analysis of the wider Women's Health Initiative Study and involved 136,000 women aged between 50 and 79.

Comparisons were made between the 5,500 women who had been prescribed antidepressants since being enrolled in the research and those who had not. There was no difference in the rates of heart attacks but those on antidepressants were 45 per cent more likely to suffer a stroke.

It is not known why there is a link and the researchers said they could not rule out that some of the effect may be due to the depression rather than just the drugs. The drugs may affect how blood clots, the study said.

The findings were published in the journal Archives of Internal Medicine.

This latest news of deadly side effects comes on the heels of a series of public health warnings on use of antidepressant drugs beginning in 2003 after clinical trials showed they increased the risk of suicidal thoughts and behaviors in children and teens.

According to a government study, antidepressants have become the most commonly prescribed drugs in the United States. They're prescribed more than drugs to treat high blood pressure, high cholesterol, asthma, or headaches.

More than 164 million prescriptions were written in 2008 for antidepressants, totaling $9.6 billion in U.S. sales.

Use of antidepressant drugs in the United States doubled between 1996 and 2005.

About 6 percent of the population was prescribed an antidepressant in 1996 -- 13 million people. This rose to more than 10 percent or 27 million people by 2005.

"Significant increases in antidepressant use were evident across all sociodemographic groups examined, except African Americans," Dr. Mark Olfson of Columbia University in New York and Steven Marcus of the University of Pennsylvania in Philadelphia have written in the Archives of General Psychiatry.

"Not only are more U.S. residents being treated with antidepressants, but also those who are being treated are receiving more antidepressant prescriptions," they added.

Drugs that affect the brain chemical serotonin like GlaxoSmithKline's Paxil and Eli Lilly and Co’s Prozac are the most commonly prescribed class of antidepressant. But the study found the increased use in all classes of the drugs.

Olfson and Marcus looked at the Medical Expenditure Panel Surveys done by the U.S. Agency for Healthcare Research and Quality, involving more than 50,000 people in 1996 and 2005.

"During this period, individuals treated with antidepressants became more likely to also receive treatment with antipsychotic medications and less likely to undergo psychotherapy," they wrote.

SOCIAL ACCEPTANCE

The survey did not look at why, but the researchers made some educated guesses. It may be more socially acceptable to be diagnosed with and treated for depression, they said. The availability of new drugs may also have been a factor.

"Although there was little change in total promotional spending for antidepressants between 1999 ($0.98 billion) and 2005 ($1.02 billion), there was a marked increase in the percentage of this spending that was devoted to direct-to consumer advertising, from 3.3 percent ($32 million) to 12 percent ($122.00 million)," they added.

Dr. Eric Caine of the University of Rochester in New York said he was concerned by the findings. "Antidepressants are only moderately effective on population level," he said in a telephone interview.

Caine, who was not involved in the research, noted that several studies show therapy is as effective as, if not more effective than, drug use alone.

"There are no data to say that the population is healthier. Indeed, the suicide rate in the middle years of life has been climbing," he said.

Olfson and Marcus said out-of-pocket costs for psychotherapy and lower insurance coverage for such visits may have driven patients away from seeing therapists in favor of an easy-to-prescribe pill.

In February 2005, the U.S. Food and Drug Administration added its strongest warning, a so-called black box, on the use of all antidepressants in children and teens.