Antidepressants Linked to Increased Risk for Death, Stroke in Postmenopausal Women
December 22, 2009 — Postmenopausal women taking either a tricyclic antidepressant (TCA) or a selective serotoninreuptake
inhibitor (SSRI) appear to be at increased risk for all-cause mortality, and SSRIs users seem to be at increased
risk for hemorrhagic and fatal stroke, although the absolute event risks are low, according to an analysis from the
Women's Health Initiative (WHI) study.
In contrast, compared with women who did not use antidepressants, "those using SSRIs had a 45% increased relative
risk of incidence stroke and a 32% increased risk of death in models stratified on propensity and adjusted for multiple
covariates," the investigators report. TCA use in turn was associated with a 67% higher relative risk for all-cause death
(hazard ratio [HR], 1.67; 95% confidence interval [CI], 1.33 - 2.09). The TCAs also increase stroke risk, but not
significantly so.
"Depression is still a much more established risk factor for cardiovascular disease (CVD) than antidepressants, so it's
not as though not taking an antidepressant removes the risk because then you have untreated depression, which itself is
risky," Dr. Smoller told Medscape Psychiatry. "But if a woman is concerned about taking medication, there are alternative
treatments for depression, such as cognitive behavioral therapy, which can be effective."
Pam Harrison Journalist for Medscape from Arch Intern Med. 2009;169: 2128-213;2140-2141.

Chocolate Linked to Lower Stroke and Stroke Mortality Risk
Susan Jeffrey
February 12, 2010 — Just in time for Valentine's Day, a new systematic review from Canadian researchers suggests
higher chocolate consumption may be associated with a lower risk for incident stroke and stroke-related mortality.
Results of 2 prospective cohort studies showed, respectively, a 22% reduction in stroke risk for those who had 1
serving of chocolate per week and a 46% reduction in stroke mortality from weekly consumption of flavonoids in 50
g of chocolate vs no consumption. A third study showed no association between chocolate intake and stroke or
death.
However, the number of studies looking at this relationship was small, senior author Gustavo Saposnik, MD, from
St. Michael's Hospital and the University of Toronto, Canada, told Medscape Neurology. "We need more prospective
studies that specifically identify the type of chocolate and the amount, including the amount of flavonoids included in
the composition of the chocolate, to make more valid conclusions," he said.

Comments: I don't think we can conclude that chocolate is the substitute of choice for antidepressants (darn!), though some women might disagree. But there are many underlying nutritional deficiencies or imbalances which can contribute to depression. Chinese medicine, which includes dietary therapy, lifestyle choices, along with acupuncture and herbal medicine look at the individual rather than the "named condition". So 8 people with depression would most likely each receive quite different therapies, herbs, and nutritional protocols. While a person may still need to continue taking antidepressants, Chinese and nutritional medicine work to harmonize and balance underlying causative factors and to nourish the person from the inside out. Through examination personal history, family history, bloodwork,  along with pulse, tongue and other diagnostic parameters, much can be done to help a person towards optimal health to help prevent incidence of stroke and cardiovascular disease. Nowadays, bloodwork reveals many factors that will indicate specifically which nutrients would be most helpful for an individual. This nutritional work helps optimize the effects of acupuncture and herbal medicine.