Anti-depressants 'up stroke risk'

BBC News

Post menopausal women who take anti-depressants face a small - but statistically significant - increased risk of a stroke, research suggests.

Anti-depressants are widely prescribed

The US study was based on 136,293 women aged 50 to 79, who were followed for an average of six years.

Anti-depressant users were 45% more likely to have a stroke than women not taking the drugs.

The data, published in Archives of Internal Medicine, is taken from the Women's Health Initiative Study.

When overall death rates were examined, those on anti-depressants were found to have a 32% higher risk of death from all causes during the study than non-users.

The researchers stressed that the overall risk of a stroke was relatively small. Even for women on anti-depressants, it was less than one in 200 chance in any given year.

However, they said that because so many women were taking anti-depressants the effect would be significant across the entire population.

It is not clear whether taking anti-depressants is solely responsible for the increased risk of a stroke.

Depression itself is known to be a risk factor for cardiovascular problems.

The researchers tried to take this into account in their analysis of the data - but could not rule out the possibility that it influenced the final results.

The study found no difference in stroke risk between the two major classes of anti-depressants, selective serotonin reuptake inhibitors (SSRIs) or tricyclic anti-depressants (TCAs).

However, the SSRIs did appear to convey a higher risk of hemorrhagic stroke caused by a bleed in the brain.

Lead researcher Dr Sylvia Wassertheil-Smoller, of Albert Einstein College of Medicine, stressed that treatment for depression was important, and that women should not stop taking prescribed medication without first consulting their doctor.

She said: "You have to weigh the benefits that you get from these antidepressants against the small increase in risk that we found in this study."

Known links

The researchers said follow-up studies were needed before any firm conclusions could be drawn.

Dr Jordan Smoller, of Harvard Medical School, who also worked on the study, said: "We need to study this association more to determine exactly what it signifies."

Joanne Murphy, for The Stroke Association stressed the study showed that overall risk for women taking anti-depressants was relatively small.

She said "We are already aware of links between depression and the risk of stroke and we are currently funding further studies to look into this.

"Everyone can help reduce their risk of stroke by making lifestyle changes, such as reducing their blood pressure, giving up smoking, reducing alcohol intake, improving their diet and getting plenty of exercise."

Ellen Mason, of the British Heart Foundation, said: "Severe depression can be debilitating and even fatal, so it is important to weigh up any small increase in the risk of stroke with the benefits of treating depression."

Bridget O'Connell, from the mental health charity Mind, said antidepressants produced a range of side effects that affected people in different ways.

She said: "Many people can experience huge benefits from taking antidepressants and it's important they work with their GP to identify both the plus points and the drawbacks, and weigh up what treatment is best for them."

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'Risky donor' kidney transplants prove successful

By Michelle Roberts
BBC News health reporter
Surgeons say they have had success with a controversial transplant technique that uses risky donor kidneys containing cancerous masses.

Donor organs are in short supply

So far five patients have been treated by the team at Baltimore's University of Maryland School of Medicine.

The US surgeons say the technique offers a vital lifeline to patients with end-stage renal failure who could die waiting for a healthy donor organ.

None of the patients has yet developed cancer urology journal BJUI reports.

Before the transplants took place, the doctors said they had detailed discussions with the patients and the donors about the discovery of the cancer in the donor kidneys so that they were both aware of the risks, including recurrence of the cancer.

Urologist and head of the surgical team, Dr Michael Phelan, said: "Transplanting a living donor kidney which has been affected by a renal mass is controversial and considered high risk.

"However, the ongoing shortage of organs from deceased donors, and the high risk of dying while waiting for a transplant, prompted five donors and recipients to push ahead with surgery after the small masses were found in the donor kidneys."

Measured risk

The kidneys were removed from the donors, put on ice and taken to the operating rooms for preparation for transplantation.

The surgeons then removed all visible traces of the tumours - five masses ranging from 1cm to 2.3cm in size, three being malignant and two benign - before transplanting them in to the recipients.

One of the recipients has since died, from an unrelated accident.

But the remaining four are well between nine and 41 months on.

Dr Phelan told the Journal of the British Association of Urological Surgeons this was proof that 'risky' kidneys could be a viable option for some.

He said: "The current study provides evidence to suggest that kidneys from donors with renal masses offer a minor, yet feasible, solution to the current organ shortage.

"These organs can be transplanted into recipients with limited life-expectancy on haemodialysis after careful removal of the renal masses.

"However, diligent follow-up of the donor and recipient is imperative in these cases."

Keith Rigg, medical advisor for the charity Kidney Research UK, said: "New initiatives to increase the number of life changing transplants are welcomed.

"The results of removing small tumours from kidneys prior to transplantation are encouraging from this small study.

"It is important though that the potential risks and benefits are fully discussed with the donor and recipient, and that the recipient of the kidney is subject to long term close scrutiny, to ensure that any risks in the long term are minimized."

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Loneliness makes cancer 'more likely and deadly'

BBC News

Fresh evidence adds weight to suggestions that loneliness makes cancer both more likely and deadly.

Doctors know depressed cancer patients have poorer survival rates

Work in Proceedings of the National Academy of Science shows social isolation tips the odds in favour of aggressive cancer growth.

Rodents kept alone developed more tumours - and tumours of a more deadly type - than rats living as a group.

The researchers put it down to stress and say the same may well be true in humans.

Cancer experts say more work is needed to prove such a link in people.

Lead investigator Gretchen Hermes, of Yale University, said: "There is growing interest in relationships between the environment, emotion and disease.

"This study offers insight into how the social world gets under the skin."

Stress

Doctors already know that cancer patients who are depressed tend to fare worse in terms of survival.

And previous research has suggested that social support can improve health outcomes for patients with breast cancer.

In the latest study, the researchers found that isolation and stress trebled the risk of breast cancer in the naturally sociable Norway rats.

Outcast rodents developed 84 times the amount of tumours as those living in tight-knit social groups, and the tumours also proved to be more aggressive.

The isolated mammals also had higher levels of the stress hormone corticosterone and took longer to recover from a stressful situation than fellow Norway rats.

The researchers ultimately hope their work will help cancer patients.

Lifestyle

Co-researcher Martha McClintock, a psychologist at the University of Chicago, said: "We need to use these findings to identify potential targets for intervention to reduce cancer."

Ed Yong, of Cancer Research UK, said: "This study was done in rats.

"Overall, research in humans does not suggest there is a direct link between stress and breast cancer.

"But it's possible that stressful situations could indirectly affect the risk of cancer by making people more likely to take up unhealthy behaviours that increase their risk, such as overeating, heavy drinking, or smoking."

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