Should you take antidepressants – and if so, which one?

It was only after I survived a heart attack that I first got an insider’s perspective on how it actually feels to be depressed.  Really depressed. Really, seriously depressed. Up until then, like many of you reading this, I was disdainful of this particular mental health diagnosis, often silently smirking things like: “Oh, for Pete’s sake, why can’t they just pull up their socks, quit whining, and get on with it?”

But after my heart attack, absolutely convinced by every twinge that yet another horrific cardiac event was imminent, I somehow fell into the grip of an icy, low-grade terror, what Frances Perkins has described as “the slow menace of a glacier”. I knew something was terribly wrong with me, but could not seem to pull myself out of this dark hole that was my new life.

Later, while at Mayo Clinic, I was actually relieved to learn that these ongoing feelings of profound despair were common among heart patients. In fact, I learned from cardiologists there that up to 65% of heart attack survivors experience significant depression, yet fewer than 10% are appropriately identified.

Cardiac psychologist Dr. Stephen Parker (and a fellow heart attack survivor who also experienced severe depression himself) writes:

“I think the depression and anxiety following a heart attack are different than the depression and anxiety that most therapists encounter, and both are going to be more resistant to treat because there are damned good reasons to feel anxious and depressed. 

“A heart attack is a deeply wounding event, and it is a wound that takes a long time to recover from, whatever the treatment.”   Continue reading

Johnson & Johnson recalls Extra-Stinky Tylenol

Years ago, I used to teach public relations courses called Reputation Management to corporate suits.  When I singled out companies that had somehow managed to weather bad press to emerge with reputations well intact, there was one at the top.

That company poster child was, hands down, Johnson & Johnson.

In fact, for many years the Forbes list of 100 Most Admired Companies featured J&J as their perennial list-topper. And the exemplary way the company had swiftly stick-handled its catastrophic Tylenol murders scandal in 1982 continues to be taught in PR, journalism and crisis communications classes.

But those heady days must seem far, far away now, with increasing reports of tainted J&J drug recalls. As Consumer Reports Health describes it, a nauseatingly bad smell to its products has been blamed for stinking up several different types of Tylenol, the antipsychotic drug Risperdal, HIV/AIDS drug Prezista, and two lots of the anti-epilepsy drug Topamax among many others. In fact, the agency reports that recalls like these have cost J&J almost $900 million in sales last year alone.   Continue reading

“You can lead a cardiologist to water but, apparently, you cannot make him drink”

When it comes to interventional cardiology – that’s using balloon angioplasty* and metal stents to open up blocked coronary arteries – it seems that medical evidence is still taking a back seat to doctors’ deeply ingrained practice patterns. Case in point, a warning from the health journalism watchdogs at Health Beat:

“Even though many well-designed clinical studies conclude that drug therapy alone can reduce the risk of heart attack and death in people with stable coronary artery disease just as well as more expensive invasive procedures, many cardiologists continue to use interventions like propping open blocked arteries with costly stents instead of first trying medication.”

Or, as the Los Angeles Times put it in a piece called Cardiologists Rush to Angioplasty Despite Evidence for Value of Drugs:

“You can lead a cardiologist to water but, apparently, you cannot make him drink.”  Continue reading