SSRIs lead to increased complications, including stroke, in depressed post-menopausal women

Selective serotonin uptake inhibitors (SSRIs) such as fluoxetine (Prozac, Eli Lilly) and sertraline Hcl (Zoloft, Pfizer) present a small but notable increased risk of stroke and death in depressed post-menopausal women, according to a new study. However, given that depression itself is a well-established risk factor for early death and heart disease, women who take the medications shouldn’t necessarily stop taking them.

“Women should not stop taking the medications based on this one study,” Jordan W. Smoller, MD, of Massachusetts General Hospital, Boston, told Reuters Health. “What our study does is give patients and doctors a little bit more information about the risk-benefit calculation for older women.”

Antidepressant use in the United States has more than quintupled since the early 1990s, Dr. Smoller and his colleagues note in their report in the Archives of Internal Medicine.

Dr. Smoller studied 136,293 post-menopausal women, none of whom were taking antidepressants at the study's outset. After about 6 years, 5,496 of the study participants started taking antidepressants. While there was no association between antidepressant use and heart disease, the researchers did find that women taking SSRIs had a 45% increase in risk of stroke and a 32% increase in risk of dying from any cause during follow up, compared to nonusers. These numbers represent "relative risk”, according to researchers. The actual risk of stroke or death for women taking the medications was higher than for women who weren't using them, but it was still quite small.

The report by Reuters Health went on to say that the effect observed with antidepressants could have been related to the fact that women who used the medications had other risk factors that couldn't be completely accounted for-like being depressed.