| Long-Term Use of Conventional Antidepressants
A recent comprehensive study suggests that long-term antidepressant use may double the risk of heart disease, specifically increasing the risk of coronary heart disease, cardiovascular disease mortality, and all-cause mortality. The study examined the risks associated with different classes of antidepressants, including selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and others.
A recent University of Bristol-led study, published in the British Journal of Psychiatry Open, analyzed data on long-term antidepressant use and its association with various health outcomes. Key findings were that long-term antidepressant use, defined as six months, was associated with a twofold higher risk of developing as well as dying from coronary heart disease. Many people were started on these medications by their primary care provider and, despite the safety concerns and lack of evidence that they are effective over time, remain on them for years. The authors of the article urge patients and clinicians to more closely monitor the cardiovascular status of anyone on long-term antidepressants.
Regeneration Therapies
I have been closely watching and writing about the growth of clinics offering various “regeneration” modalities. In my research on the various clinics offering alternative modalities, those offering stem cells are by far the most common, most lucrative, and potentially the most dangerous in the absence of basic safety measures. This industry, as with many others related to the practice of medicine, is grossly underregulated or simply unregulated in Mexico, especially when compared to the US, Europe, and Canada. In a review of regeneration modalities, a well-respected Mexican academic and researcher notes that in Mexico, human blood products are sold in a nontransparent market, with no compelling reason to provide rigorous (albeit costly) oversight.
In view of the critical safety-related issues, you simply cannot know with any degree of certainty that the product injected into you is indeed made up of your own stem cell line and that they have been safely processed and prepared. One must rely on the transparency, honesty, and openness of treating physicians.
I am less concerned about the relative safety of other “alternative” modalities common here, such as IV administration of rehydration fluid accompanied by assorted vitamins and other agents, such as medication for lead toxicity (called chelation therapy). While I may question their effectiveness, I am not as concerned about the safety of their use if basic measures are in place to ensure product stability and sterility of the infusions as well as the IV lines. Most of the ingredients available IV can be taken by mouth, thus avoiding costs and the risk of infection.
The intravenous route of administration does provide very rapid relief of dehydration symptoms (as well as some symptoms related to altitude) such as weakness and lethargy. The initial flush of vitamins, especially various types of Vitamin B, can be stimulating and many find them “therapeutic.” A warning is warranted here: ask if there are any antibiotics being administered (and what type and why). The only reason to include antibiotics is if there is an infection causing diarrhea or vomiting. A single jolt of an antibiotic is useless and can obscure or delay an accurate diagnosis of the source of a gastrointestinal infection.
Should You Get a Measles Immunization?
Many expatriates have expressed concern about the recent measles outbreaks in the United States and are asking if they should consider getting vaccinated here or in the US. Here are a few facts to help you make a decision about your own risk:
• Measles is extraordinarily contagious, far more than COVID-19. For example, one person with measles in a sports stadium infected 16 people, including someone sitting on the farthest side of the stadium from the infected
athlete.
Here are Some Key Considerations:
1. Current Outbreak Risks:
Measles outbreaks in the U.S. are likely to spread to popular tourist destinations, such as Mexico. While Mexico generally has a high vaccination rate for measles, limited surveillance can mean that outbreaks may go undetected in their early stages.
2. Vaccination History:
The measles vaccine was first introduced in the United States in 1963. Individuals born before 1957 typically do not need a measles vaccine since they likely contracted the disease during childhood when it was widespread.
3. At-Risk Groups:
Those born between 1957 and 1963 may have a reasonable chance of having had measles but could also have been vaccinated. Thus, their risk of contracting the disease now is relatively low.
4. Vaccination Status:
Most people born after 1989 were fully vaccinated with two doses of the MMR (measles, mumps, and rubella) vaccine, which contains a live but weakened virus and offers strong, long-lasting immunity.
5. Inactive Vaccine Concerns:
A small number of individuals vaccinated between 1963 and 1967 may not be fully protected and should consider getting a booster dose of the live attenuated MMR vaccine.
Reporting from San Miguel de Allende,
Deborah Bickel
Be Well Patient Advocate
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