Long Term Zoloft/Sertraline, or other SSRI Treatment, might increase Coronary Artery Atherosclerosis and stroke risk

[GeorgeGlass]

Effects of Long Term Zoloft/Sertraline Treatment and Depression on Coronary Artery Atherosclerosis in Premenopausal Female Primates.This study was done on female monkeys only. Thus, it might be safe to assume that male monkeys would have had similar results. These results could be caused by depression more than the SSRIs but the SSRIs did not reduce depression in this study, so it might be better not to take the SSRIs at all, especially if the person already has coronary artery disease/plaque buildup in the heart. I have hereditary coronary artery disease that I never know about until I was about to get prostate cancer surgery. I have always been exercising and playing sports and eating pretty well my entire life. Nowadays, I fight mild depression (caused by cancer and castration meds) by exercising, listening to music I love, on good headphones, and drinking Jade Leaf Matcha green tea powder. I feel happiest after jogging with the headphone music playing. Jogging in outdoors is even more impactful than on a treadmill. Here is some of the key info from the study report: "There has been much discussion over the last several years about whether SSRIs are safe for treating depression in CHD patients (21, 22). Some have gone so far as to recommend SSRIs to inhibit atherosclerosis progression (23). These recommendations stem from evidence of perturbed cardiovascular risk factors in depression including arrhythmias, platelet reactivity, proinflammatory processes, hypothalamic-pituitary-adrenal (HPA) function, and low high-density lipoprotein cholesterol (HDLC) concentrations in women (9, 24–28). Of these risk factors, the available evidence suggests that SSRIs have inhibitory effects on platelet reactivity (29) and inflammatory processes (30, 31) although evidence that these affects have cardiovascular significance is scarce. Conversely, SSRIs also have been observed to have adverse effects on CHD risk factors including increasing body weight (BW), body mass index (BMI), waist circumference, fasting glucose, total plasma cholesterol (TPC), low density lipoprotein cholesterol, and triglyceride concentrations (32–34), all factors that may be affected by food consumption. It is notable that many disorders for which SSRIs are commonly prescribed, such as depression, also may affect food consumption. Since all the SSRI-CHD risk factor studies assessed patient populations, the effects of SSRIs on these CHD risk factors are confounded by the disorder for which they were prescribed.There are no experimental investigations of the effects of SSRIs on CAA extent and severity, and few long term clinical studies of the effect of SSRI use on CHD morbidity and mortality. SADHART (Sertraline AntiDepressant Heart Attack Trial) demonstrated that sertraline was relatively safe and efficacious in depressed patients with ischemic heart disease but was underpowered to detect a mortality difference between sertraline and placebo. Secondary analyses of the ENRICHD (ENhancing Recovery in Coronary Heart Disease) trial suggested that SSRIs in myocardial infarction patients might reduce subsequent morbidity and mortality but the trial was not designed to detect these relationships (35, 36). More recently, Rieckmann et al observed increased cardiovascular morbidity and mortality in patients using SSRIs compared to non-SSRIs or no antidepressant, in a 42 month follow up study of CHD patients (37).In contrast, several studies suggest that SSRI use may increase the risk of ischemic stroke. Since ischemic stroke is due to cerebrovascular atherosclerosis and its sequelae, it may indicate atherosclerosis in other arterial beds. A recent meta-analysis of these studies suggests that the use of SSRIs is associated with an odds ratio of 1.48 (CI=1.08, 2.02) for ischemic stroke (38). Since these were observational studies, the effects of SSRIs may be confounded by the disorder for which they were prescribed. For this reason, a subgroup meta-analysis was done of the studies in which potential confounding due to depression was controlled by adjusting for severity of depression and/ or by exclusively selecting patients with depression. In this subgroup analysis, SSRIs still increased the risk of ischemic stroke. While these observations are suggestive, they do not address whether SSRIs affect the progression of atherosclerosis per se. However, there was a recent report of an association between increased carotid intimal-medial thickening, a powerful predictor of myocardial infarct risk (39), and SSRI treatment in a study of twins discordant for SSRI use (reported by Shah et al at the 2011 American College of Cardiology Scientific Sessions). In addition, among women with symptoms of myocardial ischemia, the use of antidepressant medication was associated with subsequent cardiovascular events (e.g. nonfatal myocardial infarction, stroke, congestive heart failure, unstable angina) (40).Taken together, these observations of associations of worsened cardiovascular risk factors, increased ischemic stroke incidence, and carotid intimal-medial thickening with SSRI use suggest a need for better information concerning SSRI effects on the development and progression of atherosclerosis. As long term randomized clinical trials are unlikely due to cost and ethical considerations, preclinical investigations are needed. Here we used adult female cynomolgus monkeys (Macaca fascicularis) because they are among the best models of social stress, depression, and atherosclerosis pathogenesis. In response to the consumption of a Western-like diet, these animals develop arterial plaques that are similar in location and composition to those of human beings (41).Adult female cynomolgus monkeys are also an established model of the comorbidity of depression and CAA (25, 42, 43). Like people, monkeys may respond to the stress of low social status with depressive behavior accompanied by perturbations HPA, autonomic nervous system, lipid metabolism, ovarian, and neural serotonergic system function, all of which are associated with exacerbated CAA (25). Depressed female monkeys develop about four times more CAA than their nondepressed counterparts (43). Thus, this is an ideal model in which to study the effects of long term SSRI treatment on CAA and associated risk factors. Since SSRIs are prescribed for many disorders other than depression, both depressed and nondepressed monkeys were studied. We hypothesized that SSRI treatment would result in less CAA, and this affect would be most apparent in depressed monkeys as they develop the most CAA."Study Report link: ncbi.nlm.nih.gov/pmc/articl...

[maley2711]

Does this somehow relate to PCa????????

[GeorgeGlass in reply to maley2711]

Yes, because many men with PCa have depression, so they take anti-depressents. Those anti-depressants combined with heart stressing ADT treatments can make heart disease and CAD worse, thus increasing the chances of death by heart attack. Many men with PCa die of heart disease/attacks.

[maley2711 in reply to GeorgeGlass]

so, consider dropping the anti-depressant? Don't many men without PCa die of CVD?