Treatment of affective disorders in cardiac disease

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Patients with cardiovascular disease (CVD) commonly have syndromal major depression, and depression has been associated with an increased risk of morbidity and mortality. Prevalence of depression is between 17% and 47% in CVD patients. Pharmacologic and psychotherapeutic interventions have long been studied, and in general are safe and somewhat efficacious in decreasing depressive symptoms in patients with CVD. The impact on cardiac outcomes remains unclear. The evidence from randomized controlled clinical trials indicates that anti-depressants, especially selective serotonin uptake inhibitors, are overwhelmingly safe, and likely to be effective in the treatment of depression in patients with CVD. This review describes the prevalence of depression in patients with CVD, the physiological links between depression and CVD, the treatment options for affective disorders, and the clinical trials that demonstrate efficacy and safety of antidepressant medications and psychotherapy in this patient population. Great progress has been made in understanding potential mediators between major depressive disorder and CVD-both health behaviors and shared biological risks such as inflammation.

Original languageEnglish (US)
Pages (from-to)127-140
Number of pages14
JournalDialogues in Clinical Neuroscience
Volume17
Issue number2
StatePublished - 2015

Keywords

  • Antidepressant
  • Anxiety
  • Cardiac disease
  • Cardiovascular disease
  • Coronary artery syndrome
  • Depression
  • Post-MI
  • SSRI
  • Treatment of depression or anxiety

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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