Antidepressants May Raise Women's Stroke Risk

But the bump in odds is small and shouldn't worry most users, researcher says

By Ed Edelson
HealthDay Reporter

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MONDAY, Dec. 14 (HealthDay News) -- Older women who take antidepressants may have a small but statistically significant increased risk of stroke and death compared to women not on the medications, a new study finds.

"But statistical significance can be different from clinical significance," stressed Dr. Jordan W. Smoller, an associate professor of psychiatry at Harvard Medical School, and lead author of a report in the Dec. 14 issue of Archives of Internal Medicine. "It is possible that a statistically detectable effect may not be a problem for most people."

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The study compared six-year data on 5,500 postmenopausal women who began taking antidepressants after enrolling in the Women's Health Initiative trial to data on more than 130,000 who did not take the drugs.

It found that women on selective serotonin uptake inhibitors (SSRIs, which include Celexa, Paxil, Prozac and Zoloft) had a 45 percent increase in risk for stroke and a 32 percent increase in risk for death from any cause, compared to non-users. Similar results were found for women on tricyclic antidepressants.

But the overall risk for any one woman remained very small, the authors stressed.

"The annual risk [of stroke] was 0.3 percent for women who did not take antidepressants, and ranged from 0.4 to 0.5 percent for women who did," said Smoller, who is also assistant vice chairman of psychiatry at Massachusetts General Hospital. "In a sample this large, that is a statistically significant difference, but it means that by far, most women did not have a stroke."

No increased risk for other heart problems was found in the study.

So, the decision as to whether and when an older woman with depression should take an antidepressant remains, "an individualized matter between a patient and her physician," Smoller said. "This study provides one more piece of information when considering options for treating depression."

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