Pulmonary arterial hypertension is a condition characterized by abnormally high blood pressure within the arteries of the lungs. Your pulmonary arteries are responsible for transporting blood from your heart to your lungs. Among individuals with pulmonary arterial hypertension, the arteries within the lungs become constricted, which results in your heart working in overdrive.
Because your heart is working in overdrive, this leads to elevations in blood pressure within the lungs. If a person does not treat their pulmonary hypertension, it could eventually lead to heart failure and/or death. A specific type of pulmonary arterial hypertension is classified as “idiopathic,” meaning the specific cause is unable to be identified. It is this “idiopathic” subtype that is associated with antidepressant usage (based on a new study).
Antidepressants Linked to Idiopathic Pulmonary Arterial Hypertension
New research indicates that people taking antidepressants are at increased risk of developing idiopathic pulmonary hypertension (IPAH). In the 1960s, the medical community developed a serotonin theory regarding IPAH. They suspected that serotonin may be a culprit for contributing to this condition because individuals that took appetite suppressants like aminorex and fenfluramine were more likely to develop it.
These drugs are known to act as indirect agonists of serotonin, which lead researchers to consider this theory. It is known that serotonin is synthesized in cells within the pulmonary artery and can act on various surrounding muscle cells, leading to constriction and other functional changes. Despite the fact that many antidepressants and serotonergic agents have been suggested to cause this condition, the research is somewhat inconclusive – with much differing evidence.
Antidepressants Linked to IPAH, but relationship is non-causal
A new study by Benjamin Fox et al. (2014) wanted to provide more clarity on the fact that serotonergic medications may contribute to idiopathic pulmonary arterial hypertension. The goal of the researchers was to determine something relatively simple: whether antidepressant exposure is linked to idiopathic pulmonary arterial hypertension.
The researchers took a look at the UK’s “Clinical Practice Research Datalink” as well as the “Hospital Episodes Statistics” database. They examined all cases of pulmonary hypertension between January 1988 and September 2011. They tracked down all specific cases of the IPAH and looked at: age, sex, and medical history.
The results indicated that of the 195 cases, researchers discovered that using any antidepressant was associated with a 67% increased risk of developing IPAH. Did the type of antidepressant that a person took make a difference? Nope. The increased risk of IPAH was statistically consistent across all types of antidepressants. Oddly enough, in this particular analysis, there was no increased risk associated with dosage or length of antidepressant treatment.
Further research is needed…
Researchers examined a lot of data spanning over the course of 20+ years. Unfortunately they only were able to come up with 195 cases of IPAH in these records. They did discover a link between antidepressant usage and developing IPAH, but the relationship was deemed “non-causal.” They suggested a non-causal relationship because the increased risk was found across all classes of antidepressants and there was no difference in risk based on dosage.
The takeaway message from the study was: those who use antidepressants had a 67% increase towards developing IPAH. The relatively vague conclusion to this study was somewhat disappointing. Are the authors suggesting that those who use antidepressants are generally more susceptible to developing IPAH? Could it be the depression may be a causal factor for the condition? Is this study lacking in sample size and diversity among antidepressant classes and doses?
Further research is needed to determine what factors actually do cause this condition. With a small sample size of 195, this study seemed to further muddy the waters. Authors are suggesting that there could be a number of other causal factors that weren’t taken into consideration.
Do you take antidepressants and suffer from idiopathic pulmonary arterial hypertension?
It would be interesting to hear from people who have developed IPAH and have also taken an antidepressant medication. Based on your personal experience, do you think that the antidepressant may have contributed to the condition? Feel free to share your thoughts in the comments section below. Also, provided below is a link to the study that was discussed as well as a related study that you can check out if interested.
- Source: http://www.sciencedirect.com/science/article/pii/S0828282X14014469
- Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2579665/