Those options can include psychotherapies such as cognitive behavioral therapy, which have been shown to benefit many persons with depression, Smoller said.
"There are many ways to treat depression," he said. "But for serious depression, medication is often part of the treatment. For most women with serious depression, the benefits of medication outweigh the risks."
Depression itself "is a very serious and often debilitating illness that has its own effects, such as heart disease," Smoller noted. And he added that the study was not a randomized, controlled trial, which makes it difficult to distinguish the effects of depression itself from those of antidepressant medications.
Someone who is taking an antidepressant and is worried about cardiovascular problem such as stroke, "should be vigilant about risk factors such as smoking, weight and cholesterol," Smoller said.
That point was echoed by Sylvia Wassertheil-Smoller, a professor of epidemiology and public health at Albert Einstein College of Medicine, and a member of the research team (and mother of Jordan W. Smoller).
"Women who are on antidepressants should pay particular attention to other cardiovascular risk factors," she said. "There is lots of stuff that we know is effective but don't do. We know that hypertension is a risk factor, yet only a third of hypertensives have it under control."
A woman's decision about taking an antidepressant "depends on how severe and how debilitating her condition is," Wassertheil-Smoller said. "You have to weigh the risk and the benefit. But that applies to any drug, even aspirin."
It would take a major controlled trial to establish the risk-benefit ratio for antidepressants, and such a trial is highly unlikely, she said. "It would have to be a long-term trial, and you couldn't ethically assign people not to take antid
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