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SANTA BARBARA—Long-term use of the antidepressant Zoloft significantly increases coronary artery plaque buildup in pre-menopausal women, a precursor for developing coronary heart disease post-menopause, a new study finds.

 

Antidepressants like Zoloft have useful benefits beside treating depression and have become the 3rd most prescribed drugs in the US. But in post-menopausal women, whose leading cause of death is coronary heart disease, using these drugs over long periods may be doing more harm than good.

 

The findings, published today in Psychosomatic Medicine, showed that depressed pre-menopausal female monkeys taking Zoloft later develop plaque 4.9 times more than untreated depressed monkeys and 6.5 times more than treated non-depressed monkeys.

 

The adverse long-term effect of Zoloft on the coronary artery is clear, regardless of treatment in depressed versus non-depressed monkeys, the study explained.

 

The research team, led by Dr. Carol Shively at Wake Forest Medical Center, measured behavioral characteristics, physiological factors, and plaque extent in 42 pre-menopausal female monkeys. They were surveyed and tested for 3.5 years in pre-treatment and treatment phases.

 

The study used monkeys because they are the best model substitute for humans in stress and depression behaviors. They also develop arterial plaques similar to humans.

 

In pre-treatment, the monkeys were quarantined for one month, then randomly assigned to social groups with controlled environmental conditions. They were fed a Western-like diet, known to cause arterial plaques, and were observed for signs of depression and anxiety. At the end of pre-treatment, a segment of the iliac artery in the pelvis was cut out to obtain a starting measurement of plaque extent.

 

During treatment, the monkeys were randomly reassigned. The treatment group received Zoloft doses daily. In contrast, the placebo group received an identical pill with no drug inside. After treatment, a segment of each of the three coronary arteries was cut out to measure the extent of plaque growth.

 

Zoloft was found to decrease anxiety but not depression. It also caused greater plaque buildup in the coronary arteries.

 

Body weight, heart rate, cholesterol, and fat levels, other factors for coronary heart disease, were also tested in both phases. None of these factors caused worsened effects, the study noted, which implies that more research needs to be done to discover the biological pathway for the increase in artery plaque.

“But since the data points to increased plaque growth, “Dr. Shively writes, “a conservative approach to prescribing SSRIs for long time periods may be warranted.”

 

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