Confirmed: Heart Problems Linked to SSRI Antidepressants

February 13, 2013
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Heart Rhythms Affected in Nearly One in Five Patients

The new study, which involved data from more than 38,000 adults, found that patients taking Celexa or certain other antidepressants called serotonin reuptake inhibitors (SSRIs) had a significantly longer QT interval, which is an indicator of abnormal heart rhythms. The disturbance increased with greater doses of the drugs.

In all, nearly one in five patients taking these drugs had longer QT intervals. In an updated drug safety communication from the FDA, it's noted that Celexa "use at any dose is discouraged in patients with certain conditions because of the risk of QT prolongation." The FDA continued:³

"Changes in the electrical activity of the heart (specifically, prolongation of the QT interval of the electrocardiogram [ECG]) can lead to a risk of an abnormal heart rhythm called Torsade de Pointes, which can be fatal.

Patients at particular risk for developing prolongation of the QT interval include those with underlying heart conditions and those who are predisposed to having low levels of potassium and magnesium in the blood.

...Citalopram [Celexa] is not recommended for use at doses greater than 40 mg per day because such doses cause too large an effect on the QT interval and confer no additional benefit... Seek immediate care if you experience an irregular heartbeat, shortness of breath, dizziness, or fainting while taking citalopram."

Antidepressants Clearly Linked to Heart Disease, Stroke, and Other Serious Risks

The above-referenced study is only the latest to highlight the very real heart risks posed when you take antidepressant drugs. For instance, antidepressant use has been linked to thicker arteries, which could contribute to the risk of heart disease and stroke.⁴

This is in addition to the already heightened risk for heart disease that accompanies depression. This was true both for SSRIs and antidepressants that affect other brain chemicals, so while the researchers speculated that the vascular changes may be due to changes in serotonin, the underlying cause is still undetermined.

Newer antidepressants also raise your risk of bleeding and stroke,⁵ and another large study of post-menopausal women found that those taking tricyclic antidepressants or SSRIs were 45 percent more likely to suffer a fatal stroke.⁶ The research also found that overall death rates were 32 percent higher in women on the drugs. Aside from potentially lethal cardiac events, other serious side effects include:

Suicidal thoughts and feelings and violent behavior
Increased risk of type 2 diabetes
Problems with your immune system: SSRIs cause serotonin to remain in your nerve junctions longer, interfering with immune cell signaling and T cell growth.⁷
Problems during pregnancy: Research shows taking SSRIs during pregnancy may increase the risks of low birth weight, preterm birth, fetal death, infant death, neonatal seizures, and the need for mechanical ventilation.⁸
Brittle bones: Research suggests taking an SSRI may double your risk of bone fractures.⁹ This is because serotonin is also involved in the physiology of bone. If you alter serotonin levels with a drug, it can result in low bone density, boosting fracture risk.

Antidepressants May Work No Better Than Placebos

Depression can absolutely devastate your health and life. However, using antidepressants as the primary (or only) treatment option is simply not advisable, especially if the one suffering from depression is a child or teenager. Whereas severe depression can indeed progress to suicide if left untreated, antidepressant drugs have been shown to CAUSE both suicidal and homicidal thoughts and behaviors, along with other potentially life-threatening health risks.

It's important to understand that research suggests there is little evidence that SSRIs have any benefit to people with mild to moderate depression, and they typically work no better than a placebo.¹⁰ One meta-analysis published in PLoS Medicine¹¹ concluded that the difference between antidepressants and placebo pills is very small—and that both are ineffective for most depressed patients. Only the most severely depressed showed any response to antidepressants at all, and that response was quite minimal.

In an interview, Pulitzer Prize nominee Robert Whitaker also explained that research suggests the use of antidepressant drugs may actually result in more relapses back into depression in the long run. In other words, these drugs may be turning depression into a more chronic condition.

My clinical experience leads me to believe that the only appropriate use of these dangerous medications is as a last ditch effort when the patient is at a serious risk to themselves or others. (And, of course, they must be closely monitored for lethal side effects such as suicidal and/or homicidal thoughts and tendencies.) The drugs should be continued until the condition is under control and they are out of harm's way, and then carefully weaned. This is a very similar strategy to going to the ER and seeing an orthopedic surgeon for a cast when you've fractured a major bone.

You don't use that cast the rest of your life. You use it until your bone is healed. The REAL tragedy is that most of the drug companies do not view antidepressants this way. There are enormous marketing efforts to classify normal behavior as aberrant or diseased, which then requires lifelong therapy with their drug solution.

Krill Results in Enhanced Cognitive Function and Antidepressant-like Effects

There are many natural strategies to help support healing from depression, and one that I strongly recommend is supplementing your diet with a high-quality, animal-based omega-3 fat, like krill oil. This may be the single most important nutrient to battle depression. One recent study actually found that the active components in krill oil, including both the omega-3 fats EPA and DHA as well as the antioxidant astaxanthin, enhance cognitive function and provide antidepressant-like effects.¹²

There are several potential reasons why omega-3 fats may positively influence outcome in depressive disorders. Low plasma concentrations of DHA is associated with low concentrations of brain serotonin. This decreased amount of serotonin can be associated with depression and suicide.

Not getting enough animal-based omega-3 fats is also known to change the levels and functioning of both serotonin and dopamine (which plays a role in feelings of pleasure), as well as compromise the blood-brain barrier, which normally protects your brain from unwanted matter gaining access. Omega-3 deficiency can also decrease normal blood flow to your brain, an interesting finding given that studies show people with depression have compromised blood flow to a number of brain regions.

Finally, omega-3 deficiency also causes a reduction in brain phosphatidylserine (PS) levels, which is relevant considering that PS has documented antidepressant activity in humans. Omega-3 fats such as those in krill oil have repeatedly been found to work just as well as antidepressants in preventing the signs of depression,¹³ but without any of the side effects. In fact, throughout my years of medical practice I've seen large numbers of patients be able to stop their antidepressants once they started taking omega-3 fats. So if you are currently struggling with depression, taking a high-quality, animal-based omega-3 fat supplement daily is a simple and smart choice... but it is only one important part of my overall recommendations for treating depression.

Top Strategies for Overcoming Depression Naturally

If you fail to address the root of the problem, you could be left floundering and struggling with ineffective and potentially toxic chemical Band-Aids for a long time. The tips that follow will help you to optimize your mental health at the foundational level:

Exercise – If you have depression, or even if you just feel down from time to time, exercise is a MUST. The research is overwhelmingly positive in this area, with studies confirming that physical exercise is at least as good as antidepressants for helping people who are depressed. One of the primary ways it does this is by increasing the level of endorphins, the "feel good" hormones, in your brain. It also helps to normalize your insulin and leptin signaling.
Eat a healthy diet – A factor that cannot be overlooked is your diet. Foods have an immense impact on your mood and ability to cope and be happy, and eating whole foods as described in my nutrition plan will best support your mental health. Avoiding sugar and grains is essential and will help normalize your insulin and leptin levels, while eliminating artificial sweeteners will eliminate your chances of suffering their toxic effects.
Optimize your gut health – Fermented foods, such as fermented vegetables are also important for optimal mental health, as they are key for optimizing your gut health. Many fail to realize that your gut is literally your second brain, and can significantly influence your mind, mood, and behavior. Your gut actually produces more mood-boosting serotonin than your brain does.
Get plenty of sunshine – Making sure you're getting enough sunlight exposure to have healthy vitamin D levels is also a crucial factor in treating depression or keeping it at bay. One previous study found that people with the lowest levels of vitamin D were 11 times more prone to be depressed than those who had normal levels.¹⁴ Vitamin D deficiency is actually more the norm than the exception, and has previously been implicated in both psychiatric and neurological disorders.
Address your stress – Depression is a very serious condition, however it is not a "disease." Rather, it's a sign that your body and your life are out of balance. This is so important to remember, because as soon as you start to view depression as an "illness," you think you need to take a drug to fix it. In reality, you need a way to return balance to your life, and one of the key ways to doing this is addressing stress.

Meditation or yoga can sometimes help. If weather permits, get outside for a walk. But in addition to that, I also recommend using a system that can help you address emotional issues that you may not even be consciously aware of. For this, my favorite is the Emotional Freedom Technique (EFT). If you have depression or serious stress, I believe it would be best to consult with a mental health professional who is also an EFT practitioner to guide you.

Please Seek Help if You're Struggling With Depression...

I know firsthand that depression and suicide is devastating. It takes a toll on the healthiest of families and can destroy lifelong friendships. Few things are harder in life than losing someone you love, especially to suicide. If you are currently the one struggling in a dark place, realize that oftentimes you cannot change your circumstances. You can, however, change your response to them. I encourage you to be balanced in your life. Don't ignore your body's warning signs that something needs to change. Sometimes people are so busy taking care of everybody else that they lose sight of taking care of themselves.

There are times when a prescription drug may help restore balance to your body. But it's unclear whether it is the drug providing benefits, or the unbelievable power of your mind that is convinced it is going to work. Regardless, please seek help from a qualified natural health care practitioner if you're dealing with symptoms of depression. And, if you are feeling desperate or have any thoughts of suicide, call the National Suicide Prevention Lifeline, a toll-free number 1-800-273-TALK (8255), or call 911, immediately.