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Antidepressant therapy in patients with ischemic heart disease.

Publication ,  Journal Article
Jiang, W; Davidson, JRT
Published in: Am Heart J
November 2005

Depressive disorders are common in patients with ischemic heart disease and have serious consequences in terms of the risk of further cardiac events and cardiac mortality. Among survivors of acute myocardial infarction, up to one fifth meet diagnostic criteria for major depression, and the presence of major depression carries a >5-fold increased risk for cardiac mortality within 6 months. This article reviews clinical trial data on the cardiac safety profiles of antidepressant agents with the aim of discussing clinical considerations in selecting the most appropriate treatment of comorbid depression in patients with ischemic heart disease. Tricyclic antidepressants are effective against depression but are associated with cardiovascular side effects including orthostatic hypotension, slowed cardiac conduction, antiarrhythmic activity, and increased heart rate. Selective serotonin reuptake inhibitors, by contrast, have benign cardiovascular profiles and are well tolerated in patients with cardiac disease. The safety of dual-acting serotonin and noradrenaline reuptake inhibitors has not been well studied. Intervention with a selective serotonin reuptake inhibitors has the potential to provide the depressed patient with ischemic heart disease relief from their depressive symptoms and may offer a potential improvement in their cardiovascular risk profile.

Duke Scholars

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

November 2005

Volume

150

Issue

5

Start / End Page

871 / 881

Location

United States

Related Subject Headings

  • Serotonin Antagonists
  • Risk Factors
  • Myocardial Ischemia
  • Humans
  • Drug Interactions
  • Depression
  • Cardiovascular System & Hematology
  • Cardiovascular Diseases
  • Antidepressive Agents, Tricyclic
  • Antidepressive Agents
 

Citation

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Jiang, W., & Davidson, J. R. T. (2005). Antidepressant therapy in patients with ischemic heart disease. Am Heart J, 150(5), 871–881. https://doi.org/10.1016/j.ahj.2005.01.041
Jiang, Wei, and Jonathan R. T. Davidson. “Antidepressant therapy in patients with ischemic heart disease.Am Heart J 150, no. 5 (November 2005): 871–81. https://doi.org/10.1016/j.ahj.2005.01.041.
Jiang W, Davidson JRT. Antidepressant therapy in patients with ischemic heart disease. Am Heart J. 2005 Nov;150(5):871–81.
Jiang, Wei, and Jonathan R. T. Davidson. “Antidepressant therapy in patients with ischemic heart disease.Am Heart J, vol. 150, no. 5, Nov. 2005, pp. 871–81. Pubmed, doi:10.1016/j.ahj.2005.01.041.
Jiang W, Davidson JRT. Antidepressant therapy in patients with ischemic heart disease. Am Heart J. 2005 Nov;150(5):871–881.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

November 2005

Volume

150

Issue

5

Start / End Page

871 / 881

Location

United States

Related Subject Headings

  • Serotonin Antagonists
  • Risk Factors
  • Myocardial Ischemia
  • Humans
  • Drug Interactions
  • Depression
  • Cardiovascular System & Hematology
  • Cardiovascular Diseases
  • Antidepressive Agents, Tricyclic
  • Antidepressive Agents