Posted by SLS on July 30, 2016, at 15:24:14
In reply to Re:study, posted by Tabitha on July 30, 2016, at 11:56:26
> > Let us look at this:
> > Lou
> > http://journal.frontiersin.org/article/10.3389/fphar.2012.00076/full
>
> Well, I'm glad to notice the quality of your references is improving. This looks like it might actually be a legitimate study. So let's look at the summary:
>
> "Sudden death of cardiac origin associated with the use of psychotropic drugs can occur in patients with pre-existing cardiopathies including ischemic, dilated, and hypertrophic cardiopathies. However, it is possible that psychotropic drugs can by themselves induce such pathological conditions."
>
> Yikes, it would be a bad thing if people with pre-existing heart trouble ended up dying from their anti-depressants and anti-psychotics. If other studies confirmed this, then it would become general knowledge and doctors would need to check for pre-existing heart conditions before prescribing them, particularly for elderly patients.
>
> But... isn't that kind of typical thing doctors do before prescribing any medication anyway? Is there reason to believe these medications are uniquely risky for people with pre-existing heart trouble as compared to other medications they might need? You'd probably need to consult actual doctors who have broad enough expertise to know how to proceed with treatment, instead of trying to interpret individual studies in the few open access journals by yourself.When tricyclics were used more frequently, many doctors would ask their patients to get a EKG (ECG) first because of the potential for TCA to produce cardiac bundle block and other cardiovascular side effects. Interestingly, I didn't come across this same concern when SSRIs first came out while TCA were still used routinely. SSRIs have a greatly reduced potential for CV toxicity, so there is no real need to screen people for it as protocol for SSRI use. Similarly, there is no real need to check someone's status of tinea pedis (athlete's foot) before prescribing Effexor or Geodon.
I just read something that indicated that Geodon (ziprasidone) was no more apt to cause sudden death by cardiovascular event than Zyprexa (olanzapine), despite the concerns over changes in heart rhythm (QTc prolongation). So, here again, there isn't enough concern so as to use EKG routinely.
http://www.ncbi.nlm.nih.gov/pubmed/21041245
Another study concluded that the risk of sudden death for AAPs is significantly lower than that of the older typical APs.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767168/
As was suggested, sometimes a doctor's personal clinical experience with medication is more valuable than words on a page. However, I haven't yet seen my doctor express concerns over Geodon. If I remember, I'll ask him whether or not he asks his patients with CV disease to be tested.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1090994
URL: http://www.dr-bob.org/babble/20160713/msgs/1091003.html