Related Experiment Videos
The use of antidepressant drugs in patients with heart disease
A H Glassman1, A I Rodriguez, P A Shapiro
1College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Insights
Older adults with heart disease may benefit from serotonin selective reuptake inhibitors (SSRIs), a type of antidepressant. These drugs appear safer than older tricyclic antidepressants (TCAs) for managing depression in patients with ischemic heart disease.
Area of Science:
- Geriatric Medicine
- Cardiology
- Psychiatry
Background:
- Depression and cardiovascular disease frequently coexist in aging populations.
- The comorbidity of depression and cardiovascular disease is higher than expected by chance.
- Tricyclic antidepressants (TCAs) pose significant risks for patients with ischemic heart disease.
Purpose of the Study:
- To evaluate the safety and efficacy of serotonin selective reuptake inhibitors (SSRIs) in older adults with heart disease.
- To compare the risks associated with SSRIs versus TCAs in patients with ischemic heart disease.
Main Methods:
- Review of three recent studies on SSRI safety in patients with overt heart disease.
- Analysis of safety data from a total of 94 patients.
Main Results:
- Limited evidence of harm associated with SSRI use in patients with heart disease.
- Potential beneficial effects of SSRIs observed in patients with ischemic heart disease.
Conclusions:
- SSRIs may be a safer alternative to TCAs for treating depression in patients with ischemic heart disease.
- Further research is warranted to confirm the safety and efficacy of SSRIs in this population.
Abstract:
Both depression and cardiovascular disease are common as people age and are, therefore, likely to coexist. It has become evident recently that the rate of this comorbidity exceeds substantially what is expected by chance. A major problem arises in that there is increasing evidence that the tricyclic antidepressants (TCAs) carry more risk than originally thought in patients with ischemic heart disease. This risk increases the importance of understanding both the safety and efficacy of the serotonin selective reuptake inhibitors (SSRIs) in this population. Three recent studies on safety data in patients with overt heart disease are now available: although the total of 94 patients limits the ability to make generalizations, the data that are available give little evidence of harm and even suggest that SSRIs may have beneficial effects in ischemic heart disease.