We have long written about SSRI—selective serotonin reuptake inhibitors—antidepressants, medications that block the re-absorption (reuptake) of the neurotransmitter, serotonin, in the brain to boost mood. Now, emerging research reveals that some SSRIs pose cardiac risks.
Research conducted by UK’s Medicines and Healthcare products Regulatory Agency (MHRA) revealed that a small, but serious, risk to the heart was seen in patients taking the SSRI antidepressants Celexa (citalopram) or Lexapro (escitalopram), said BBC Health News. These SSRIs can trigger a heart rhythm disturbance, according to the study, which appears in the British Medical Journal. Regulators in the United States and the UK previously warned physicians to exercise caution when prescribing these medications and have also reduced the maximum recommended dose.
The MHRA says those diagnosed with a pre-existing heart condition should undergo a heart trace to check for long QT interval, a heart rhythm disturbance, prior to taking these SSRIs, said UK Health News. “People taking these drugs shouldn’t be alarmed and shouldn’t stop taking their medication without speaking to their doctor” June Davison of the British Heart Foundation told BBC Health News.
QT interval is measured with an electrocardiogram (ECG) and varies with heart rate, becoming longer when the beat is slower and shorter with faster beats, explained BBC Health News. While some variation is normal, a longer QT interval can impact heartbeat timing and may lead to very serious health reactions, such as dizziness; fainting; and, rarely, death.
The researchers reviewed the medical records of more than 38,000 patients from New England who had recently undergone an ECG; most had been prescribed an SSRI antidepressant, and some had been prescribed methadone. Methadone patients were included for comparison purposes as methadone—which is used for pain and heroin addiction—can prolong QT interval, explained BBC Health News. All three medications were linked with a small and rare, but significantly longer, QT interval, which increased at higher doses, said BBC Health News.
We previously wrote that a another study suggested that there is too much of a risk taking SSRIs—Celexa, Lexapro, Paxil, Prozac, and Zoloft—during pregnancy, including potential increased risks for miscarriage, pre-term births, neonatal health complications, and long-term neurobehavioral abnormalities. Neurobehavioral abnormalities include autism, which suggests that SSRIs should be used to treat depression with great care, as well as sufficient counseling to those women diagnosed with depression and who are trying to become pregnant, said researchers at Beth Israel Deaconess Medical Center, Tufts Medical Center, and MetroWest Medical Center.
We also previously wrote that a growing body of research linked SSRIs to birth defects and other issues when used by pregnant women, especially in the early months of pregnancy when many women don’t realize they are pregnant. One study published by researchers at Sweden’s Karolinska Institute found that taking an SSRI antidepressant during pregnancy was associated with a two-fold increased risk of neonatal pulmonary hypertension (PPHN). Another report published in the Archives of General Psychiatry found that babies exposed to SSRI antidepressants before birth exhibit reduced head growth at birth, and are more likely to be born prematurely.
Health Canada updated the Lexapro label with a warning about the drug’s link to abnormal heart rhythm. Lexapro, linked to dose-related risks for abnormal heart rhythms, was found to cause electrical changes QT interval prolongation, according to clinical trial data.
Researchers at Canada’s McMaster University discovered that antidepressants that impact levels of serotonin in the brain can cause side effects related to any bodily process normally regulated by serotonin. Some possible side effects include birth defects in infants; sexual dysfunction, and problems with sperm development in adults; diarrhea, constipation, indigestion, bloating, and other digestive problems; and abnormal bleeding and stroke in the elderly. The study authors also reviewed three recent studies showing that elderly antidepressant users are more likely to die than non-users, even after taking other important variables into account.