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An Unpredictable Chronic Mild Stress Protocol for Instigating Depressive Symptoms, Behavioral Changes and Negative Health Outcomes in Rodents
Published on: December 2, 2015
Treating the depressed patient with cardiovascular problems
1Department of Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons, Columbia University, N.Y. 10032.
Insights
Depression significantly impacts cardiovascular disease outcomes and survival. This review covers managing affective disorders in cardiac patients, focusing on safe antidepressant use.
Area of Science:
- Cardiology
- Psychiatry
- Clinical Medicine
Background:
- Cardiovascular disease (CVD) and affective disorders, particularly depression, share complex interrelations.
- Depression is prevalent post-myocardial infarction and worsens cardiac prognosis.
- Depressed individuals face an elevated risk of sudden cardiovascular death.
Purpose of the Study:
- To explore the multidimensional relationship between cardiovascular disease and affective disorder.
- To discuss the clinical management of depression in patients with pre-existing heart disease.
- To review the cardiovascular effects of antidepressants for safe and effective treatment.
Main Methods:
- Literature review and synthesis of existing research on CVD and depression.
- Analysis of clinical observations regarding depression in post-myocardial infarction patients.
- Evaluation of cardiovascular effects of various antidepressant classes.
Main Results:
- High incidence of depression following myocardial infarction.
- Negative impact of depressive illness on cardiac disease prognosis.
- Increased risk of sudden cardiovascular death in depressed patients.
Conclusions:
- Effective management of depression is crucial for improving outcomes in cardiac patients.
- Careful consideration of antidepressant cardiovascular effects is necessary for treatment.
- Clinicians must prioritize safe and effective treatment strategies for affective disorder in severe cardiac disease.
Abstract:
A multidimensional relationship exists between cardiovascular disease and affective disorder that includes the observations that (1) there is a high rate of depression in the postmyocardial infarction period, (2) the presence of depressive illness adversely affects the prognosis of cardiac disease, and (3) depressed patients have a higher-than-expected rate of sudden cardiovascular death. The authors discuss these topics and the clinical management of depression in patients with significant preexisting heart disease. The cardiovascular effects of the tricyclic antidepressants and recently introduced nontricyclic antidepressants are reviewed with a focus on how the clinician can safely and effectively treat affective disorder in patients with severe cardiac disease.
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