Some Antidepressants From Blood Thinners May Pose a Risk for Patients With Heart Disease

Heart attack patients who take both choosy serotonin reuptake inhibitor antidepressants and antiplatelet drugs such as aspirin or Plavix cause a higher risk for bleeding than those who annihilate anti-clotting drugs not, a new study finds. Commonly prescribed SSRIs cover Zoloft, Prozac, Paxil, Lexapro and the buy Valium online.
Antiplatelet drugs arrest blood cells from sticking together and forming a blood clot. Sincerity attack patients are commonly prescribed antiplatelet group therapy to reduce their risk of another core attack. But there's an increased chance of bleeding, which increases coequal further when certain other drugs are bewitched at the same time.
 It so happens that uncountable heart attack patients be undergoing depression symptoms and are prescribed antidepressants, celebrated the researchers at McGill University in Montreal. "We're in any case concerned about how other medicine clout interact with the medicines we be aware are essential to heart health and betterment after heart attack," said Dr. Kirk Garratt, clinical pilot of interventional cardiovascular research at Lenox Hill Polyclinic in New York City.
"Although SSRIs are in use accustomed to in only a few cardiac patients, culture that SSRIs can increase jeopardy of bleeding complications could be suffering with important implications for how we care for patients after stents and other heartlessness procedures."
In the Canadian analysis, the researchers looked at more than 27,000 core attack patients, aged 50 and older, and create that patients taking aspirin or Plavix solitarily had a similar risk of bleeding. But alluring an SSRI antidepressant and aspirin increased the risk of bleeding by 42 percent, and fetching an SSRI with both aspirin and clopidogrel (dual antiplatelet treatment) increased the risk by 57 percent. Bleeding included gastrointestinal bleeding, hemorrhagic thrombosis or other bleeding that required hospitalization or occurred in the sanatorium during treatment.
The researchers also initiate that the risk of bleeding was deign in women and in patients who had angioplasty after their sensibility attack. The study appears Sept. 26 in the Canadian Medical Relationship Journal. "Ultimately, clinicians requirement weigh the benefits of SSRI treatment against the risk of bleeding in patients with outstanding depression following acute myocardial infarction," the researchers wrote in a weekly news release. They urged doctors to be vigilant when buy generic valium to nerve attack patients on antiplatelet psychoanalysis.

Black Heart Patients Undertreated For Depression

Blacks and whites with heart disease are both likely to experience symptoms of depression, but blacks are only half as likely to receive treatment for the disorder, according to a new study from Duke University Medical Center.
"This is an important finding because we know that depression is associated with a 2- to 4-fold increase in the risk of complications and death from heart disease," says James Blumenthal, PhD, a psychologist at Duke and a co-author of the study appearing early online in the American Heart Journal. "Undertreatment of depression is a serious clinical issue."
Coronary heart disease is the leading cause of death in the United States, and previous studies show that it takes a disproportionate toll among blacks
Through support from a grant from the National Institutes of Health, Duke researchers studied 864 patients (727 whites and 137 blacks) who received care at the Diagnostic Cardiac Catheterization Laboratory at the Duke Heart Center between April 1999 and June 2002. Researchers reviewed the patients' records, noting use of medications and any cardiovascular risk factors. They also asked participants to complete the Beck Depression Inventory (BDI) to assess symptoms of depression.
The scientists found that depression was common in this group: Thirty-five percent of the black patients and 27 percent of the white patients had elevated measures of symptoms of depression. But while 21 percent of the whites were taking antidepressants to treat the disorder, only 11.7 percent of the blacks were receiving treatment.
There also appeared to be important gender differences. Among those with the most severe symptoms of depression, 43 percent of white men, but only 22 percent of black men were on antidepressants. In comparison, 64 percent of white women and 67 percent of black women were taking such medications.
"These findings suggest that depression in heart disease is undertreated, and it appears that black men are suffering the most," says Silvina Waldman, MD, a cardiologist at the Duke Heart Center and lead author of the study. "It is sobering to realize that large numbers of patients are missing out on important and readily available therapeutic options."
Blumenthal says available data do not provide a clear explanation for the disparity in treatment rates, but he believes it is probably due to several factors. Studies show that depression in conjunction with medical illness tends to be under diagnosed. Blumenthal says that some physicians may not be adept at recognizing depression in minority patients and that some patients may feel that a diagnosis of depression is stigmatizing and may not feel comfortable talking about their symptoms with their doctor. Blumenthal says insurance coverage and patients' ability to pay out-of-pocket expenses may also play a role. Some patients may indeed have been prescribed antidepressants, but can't afford to have prescriptions filled - a dilemma that could affect treatment rates.
"We clearly need to do a better job of recognizing and treating depression, especially in heart patients," Blumenthal said. "We need treatments that work, treatments that are acceptable to patients, and treatments that are actually incorporated into medical practice."
Blumenthal believes that medications may not be the only way, however, to treat depression in heart disease. He is currently conducting a clinical trial (called UPBEAT) comparing aerobic exercise to antidepressants as a means of relieving symptoms of depression.