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Antidepressant drugs and cardiovascular pathology: a clinical overview of effectiveness and safety

D Taylor1

  • 1Pharmacy Department, Maudsley Hospital and Division of Pharmaceutical Sciences, King's College, London, UK. david.taylor@slam.nhs.uk

Acta Psychiatrica Scandinavica
|September 13, 2008
PubMed

Insights

Depression is linked to cardiovascular disease, increasing mortality. Some antidepressants are safe post-myocardial infarction (MI) and stroke, with certain options potentially improving survival rates.

Area of Science:

  • Cardiology
  • Psychiatry
  • Pharmacology

Background:

  • Depression and cardiovascular disease (CVD) are closely linked.
  • Depression can cause, worsen, and increase mortality in CVD patients.
  • CVD is also associated with a high incidence of depression.

Purpose of the Study:

  • To review data on the relationships between depression, antidepressants, and cardiovascular disease.
  • To assess the safety and efficacy of various antidepressants in patients with CVD.

Main Methods:

  • Structured literature searches of PubMed, Medline, and Embase databases.
  • Data review conducted in March 2008.

Main Results:

  • Many antidepressants possess cardiotoxic properties, particularly tricyclic antidepressants in overdose.
  • Certain antidepressants like reboxetine, duloxetine, and venlafaxine can increase blood pressure.
  • Some antidepressants demonstrate neutral or beneficial cardiovascular effects.

Conclusions:

  • Sertraline, fluoxetine, citalopram, bupropion, and mirtazapine appear safe post-myocardial infarction (MI), with potential mortality benefits.
  • Paroxetine and citalopram are considered safe for patients with coronary artery disease.
  • Evidence suggests various antidepressants are effective and safe for post-stroke use.
Abstract

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