Treatment of depression with antidepressant medications in patients with cardiovascular disease

Background: The prevalence of depressive disorders is higher in patients with cardiovascular disease than in the general population. Method: Considering the results of a most recently published, large epidemiological study on the excess risk of myocardial infarction in patients treated with tricyclic antidepressants compared to those treated with selective serotonin reuptake inhibitors (SSRIs) (Cohen et al.,2000), current advances in the pharmacotheray of depression in patients with cardiovascular disease will be reviewed. Results: Distinctive antidepressant medication classes are addressed to develop an appropriate pharmacotherapy of depression in patients with cardiovascular disease. Relevant psychobiological mechanisms associated with the use of antidepressant medications that may contribute to the reduction of morbidity and mortality in depressed patients with cardiovascular disease, are discussed. Conclusion: Taken together, SSRIs appear to play a major role in the effective and safe pharmacotherapy of these patients.

Reference: Cohen HW, Gibson G, Alderman MH (2000) Excess risk of myocardial infarction in patients treated with antidepressant medications: association with use of tricyclic agents. Am J Med 108:2–8