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An ultrasound study uses sound wave reflections in the body to visualize structure. Newer machines can detect minute variations in tissues. Ultrasound can measure increased thickness of arterial walls, which indicates damage and a loss of resiliency. Abnormalities in the carotids, arteries in the neck, can be detected. They correspond to changes in heart arteries, which are located too deep to be measured by ultrasound.

A current study reveals increased thickening of carotid arteries in men taking antidepressants.

The study was performed at Emory university in Atlanta, Georgia, and presented at the annual meeting of the American College of Cardiology. Antidepressant use of all types, including SSRIs (serotonin reuptake inhibitors, including Prozac and Zoloft) , was associated with a 5% increase in carotid artery thickness, corresponding to a 7% increase in the risk of having a heart attack.

The finding held true for identical twins as well. The twins taking antidepressants had thicker carotid artery walls than their siblings who were not taking these drugs.

A possible cause could be release of nerve transmitters that constrict blood vessels. It was recommended that patients with prior history of cardiovascular events should be carefully evaluated for adverse effects from antidepressant drugs. I think back on the many patients I have seen who were released from the cardiac unit on antidepressant drugs, because they were “depressed” after having suffered heart attacks. Were they being set up for more heart attacks?

Allan Sosin MD

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