Home > Madness > Psychotropic Medications Increase Cardiac Death

Psychotropic Medications Increase Cardiac Death

Honkola J, Hookana E, Malinen S, Kaikkonen KS, Junttila MJ, Isohanni M, Kortelainen ML, & Huikuri HV (2012). Psychotropic medications and the risk of sudden cardiac death during an acute coronary event. European heart journal, 33 (6), 745-51 PMID: 21920969

What do you do when you discover that the medication that you manufacture causes manifest harm to those patients that it is supposed to help?

What do you do when you prescribe that medication to your patients and instead of getting well they actually get sicker or drop dead?

What do you do when your mental health policy rests entirely upon patients taking or being forced to take medications such as these?

At what point does objective, empirical evidence come to the fore?

We have known for some time that psychotropic medications increase morbidity and mortality. What we have yet to confirm is precisely how those medications cause ill health and early death (2012,p.749). One thing of which we can be certain is that any purported cause-effect relationship between the so-called mental illnesses and higher rates of morbidity and mortality is illusory. I would suggest that this myth was created to cover the arses of those who have most to lose from the truth, that is, big pharma, psychiatrists, and the other parasites that collectively constitute the grubby business of marketing madness.

In this article, Honkola et al. (2012, p.749) conclude that there is a positive association between the use of psychotropic medications and sudden cardiac death (SCD). That association strengthens dramatically when those drugs are used in combination with anti-depressants:

A very high risk of SCD was observed in those individuals who were using both antipsychotic and antidepressant medication. The risk was particularly high with phenothiazines combined with anti-depressant medication, suggesting that the combined use of these drugs may potentiate their proarrhythmic effects at the time of an acute ischaemic event. The use of benzodiazepines, a class of drugs which do not have any recognized proarrhythmic potential, was similar between the groups, suggesting that psychiatric disorders, at least anxiety, does not increase the vulnerability to fatal events, whereas the drugs used for mental disorders have a more marked effect’ (2012, pp.749-750).

I guess that if you were pushing people off the twig 20 years or so in advance of their expected use by date, you would have good reason to be defensive about that unpleasant reality…

What we have here is a magnificent cause-effect fallacy in which some people diagnosed (sic, labelled) as suffering with depression, anxiety, schizophrenia, etc., do indeed demonstrate a tendency toward getting sicker and dying younger than everyone else (2012, p.745). The presence of these two distinct phenomena has led to an untouchable line being drawn between the two, as confirmation that the former is sole cause for the latter. That is junk science. If an undergraduate student put up such rubbish straw arguments in an academic essay, her or his lecturer would boot them out the door and into the gutter. However, big pharma and psychiatry can concoct a stupendous farrago of lies and half-truths that mental illness causes higher morbidity and mortality, without the proof necessary to back it up.

Any patient so grandiose in her or his ideas could expect to have their psychotropic medications increased…

The authors (2012, p.750) make a few recommendations:

  1. Curbing the ‘liberal off-label use’ of psychotropic medications
  2. Avoiding combined, anti-psychotic and anti-depressant treatment
  3. Promoting good physical health in people who are mentally unwell

We will look back at this marketing madness era with horror and disgust, wondering how the fuck could we have ever allowed this to happen? How could we have forced perfectly healthy people to take drugs that would trash their lives and smash them into their graves way ahead of schedule? No doubt, the instant rejoinder to that would be twofold: acknowledging that all drugs have side effects and that a diminution in physical health is the price paid for peace of mind. That sounds like a perfectly reasonable response until we remember that the primary duty of any health practitioner is to do no harm. What can be said about any doctor who, when telling or forcing patients to take psychotropic medications, fails to inform those patients about the potential side effects or worse, who obfuscates around the truth to deceive those patients into believing that it is their mental illness which is making them sick?

I note that neurological damage to the brain does cause physical ill health but mental illness is not neurological damage to the brain, right…?

Moreover, if you ever have any concerns about any medication you are taking, please seek sound medical advice…

  1. Marklewood at Serenity Lodge
    March 18, 2012 at 1:00 am | #1

    A poorly written and scary article.

    In short: If you are not a doctor OR a patient with mental illness, you are dangerous. If you are a doctor, you’re a quack. If you’re a patient, you have a problem and need therapy, because your logic is not only flawed, it’s crazy.

    Of course everyone has a right to their opinion, however wrong they might be. But, in this case, such advice as you give is lethal.

    • March 18, 2012 at 2:20 am | #2

      I thank you for your comments. You might be interested to know that in an editorial on and in the same journal from which the Honkola (2012) article was sourced, Josep Brugada wrote:

      ‘We are probably facing a new challenge: patients with psychiatric disorders are at risk of coronary events; drugs administered to them can be proarrhythmic, especially during ischaemic conditions. Careful selection of patients who are candidates to receive psychotropic drugs, according to their cardiovascular risk profile, is mandatory if we do not want to harm them. Cardiologists and psychiatrists should start thinking of the best way to establish good and reliable links between the two specialities in order to best treat what in fact are common patients’.

      • Marklewood at Serenity Lodge
        April 18, 2012 at 2:22 am | #3


  2. March 18, 2012 at 8:28 am | #4

    What a horrible article full of scary language and factual errors.

    First of all: even if it is the case that an article suggests that some drug or treatment causes more harm than good… this is not how we discuss it in a serious forum.

    Case and point: new evidence suggests that antidepressants are only effective in people who suffer from severe depression, and perform no better than placebo for mild depression (with the exception of some outliers).

    This is how a grown-up discusses the issue: http://c0nc0rdance.com/2012/03/09/do-the-latest-antidepressants-work/ — No need for scary “big pharma” talk.

    By the way, the man who runs that blog actually works for “big pharma”. While I can’t speak for the people who run those companies (whose job it is to maximize profit, for better or worse), the researchers (doctors, chemists, etc.) who work for them, for the most part, actually do care about helping people and treating disease.

    Let’s break down what you’ve got wrong:

    a) Your title: “Psychotropic Medications Increase Cardiac Death”?

    “Psychotropics”? As a general rule? “As in, this study shows that all psychotropics increase SCD rates”?? From stimulants, to depressants, to SSRI’s, neuroleptics, hallucinogens… etc. etc.?

    No. Whether “Psychotropic Medications Increase Cardiac Death” is the question the authors of this paper set to answer. The actual results of the study are that they (one research team conducting one study) found a correlation between the use of some psychotropic drugs and SCD:

    The article is refers specifically to antipsychotics (even more specifically: phenothiazines, which is only one class of antipsychotics) and antidepressants… and, more importantly, to the combination of the two.

    In fact, the authors of the article explicitly bring up that no correlation to higher rates of SCD was found for other psychotropics (such as benzos).

    b) This is one study. No need for the Fox News treatment yet. Remember those faster than light neutrinos last year?

    In particular, the statistical analysis of complex systems (like people) is very difficult to manage and make sense of. Which is why the scientific community doesn’t go into a frenzy and rewrite the books every time a study comes out suggesting this or that treatment leads to a higher chance of x.

    There are many questions this study doesn’t answer:

    How is this comparable to other complications resulting from non-treatment (not just mortality)?

    Do the people affected have anything in common, or does this cause damage across the board? (Maybe it’s just higher in men, maybe just in those of asian descent, my only carriers of some genetic variant are affected:

    For example, whether or not coffee leads to hypertension is strongly linked to genetics; a more concrete example: the val158met polymorphism of the COMT gene is strongly linked to whether dopaminergic drugs like Ritalin or Adderall will improve cognitive performance and alertness, or actually impair it — one single nucleotide polymorphism makes a world of difference in the net-result of the drug).

    > I note that neurological damage to the brain does cause physical ill health but mental illness is not neurological damage to the brain, right…?

    c) That’s great then, because… actually, yes, schizophrenia, when it is not treated, can cause permanent damage to the brain. Up to a quarter of grey matter loss in some areas of the brain. Severe “manic-depression” (bipolar), can also cause damage. These are all visible in brain scans; pretty major stuff.

    d) You don’t even consider quality of life.

    If you had a choice between 80 years of progressive insanity and loss of control over your own actions and sense of self (schizophrenia), or (following your alarming claim of -20 years’ life span,) 60 years spent actually contributing to society, your family and friends… which would you choose? — Shall I bring up the suicide rates of those with severe mental illnesses like schizophrenia and BP? — These guys aren’t killing themselves because psychosis is a fun roller coaster ride.

    e) The subjects in question were elderly people who had suffered from a cardiac event resulting in SCD (65-75 y/o… so, unless the average person lives to 95 where you are, I don’t know where you got those 20 years from). — These could have been people who were already at high risk of SCD, and the use of these drugs simply tipped the scales. (Or not: I don’t see a statement one way or the other.)

    So the study doesn’t answer this question: what is the effect of antipsychotics and antidepressants on the lifespan of healthy adults without a predisposition for SCD or cardiac disease?

    f) Instead of panicking, consider that understanding what goes wrong with current treatment is the only way to gain understanding and design better treatments that cause less harm. For now, yes, we’re our own guinea pigs. Maybe in a few decades we’ll be able to simulate a full organism in a computer and run tests of the effects of various drugs and treatments, log every variable, run a million simulations in a week, and know exactly what a drug will do to you and give you the choice. For now, sloppy old pharma is all we have. — As unethical as having an organization engineering medicine for profit is, not enough of the general public is willing to fork up a large enough portion of their own salary to fund not-for-profit and public research.

    • March 18, 2012 at 11:52 am | #5

      Putting your extreme defensiveness to one side, I can agree with your point that there is not nearly enough independent, publicly funded research into mental illness. That would explain, in large measure, why there is still so much that remains unknown about what causes mental illness, why prevalence rates are surging and why successful treatments go begging. What we need is a holistic approach to understanding mental illness, an approach that gives weight both to individual physiology and social context. We should also speak up and call those many elephants that crowd the room whenever mental illness is discussed.

      Devotees of psychotropic medications, who currently dominate the mental health field, have to start stepping out of their ideologically biased boxes and all the limitations that inflicts upon their research to instead, take an objective, open approach to their work. Most of all, I think, those who are not living the experience of mental illness (by whatever name the subject person describes her or his symptoms) need to listen to and be guided by those of us who are. As you would know, that catholic cohort includes both passionate advocates for and staunch critics of psychotropic medications. Shutting down the latter, dissenting view is neither respectful nor for that matter, good science.

      Oh, and yes, I was amused that you and the previous commentator called me a ‘fuckwit’ (or words to that effect). I blame my Irish heritage, since the Irish are congenital idiots at the best of times and on St Patrick’s Day, well…

  1. April 10, 2012 at 3:15 pm | #1
  2. April 15, 2012 at 6:20 am | #2

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