CORRESPONDENCE: LETTER TO THE EDITOR
Reply
William Whang, MD, MS* and
Christine Albert, MD, MPH
* Division of Cardiology, Columbia University Medical Center, Harkness 366, 180 Fort Washington Avenue, New York, New York 10032 (Email: ww42{at}columbia.edu).
We thank Drs. Carney and Freedland for their perspective on our study (1). We performed the analyses that they suggested by estimating separate hazard ratios for 4 categories of women from the Nurses' Health Study according to presence of severe depressive symptoms (Mental Health Index-5 score <53) and/or reported use of antidepressant medications. In multivariable analyses, the hazard ratios associated with each category are listed in Table 1. The risk of sudden cardiac death was significantly elevated among women treated with antidepressants regardless of whether they continued to show severe depressive symptoms. Although the hazard ratio was slightly higher among those who showed severe depressive symptoms, confidence intervals overlapped. Also, we did not find evidence for an interaction between the Mental Health Index 5 score category and antidepressant use in separate multivariable models that used a cross-product term. Therefore, we were unable to find strong evidence in support of the hypothesis of Drs. Carney and Freedland in our data; however, we strongly agree that further research into the prognosis of depression and treatment-resistant depression, and the underlying mechanisms, is needed.
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References
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1. Whang W, Kubzansky LD, Kawachi I, et al. Depression and risk of sudden cardiac death and coronary heart disease in women: results from the Nurses' Health Study J Am Coll Cardiol 2009;53:950-958.[Abstract/Free Full Text]
Related Article
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Treatment-Resistant Depression and Sudden Cardiac Death
- Robert M. Carney and Kenneth E. Freedland
J. Am. Coll. Cardiol. 2009 54: 958.
[Full Text]
[PDF]
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