Angiotensin Converting Enzyme Inhibitors and Risk of Mood Disorders

Williams, Lana J.; Pasco, Julie A.; Kessing, Lars Vedel; Quirk, Shae E.; Fernandes, Brisa S.; Berk, Michael

doi:10.1159/000444646

Cited by 20 publications

(24 citation statements)

References 9 publications

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“…Examples include statins, aspirin and angiotensin antagonists 788, 789, 790, 791, 792, 793. The implications are that clinicians should be actively engaged in the management of these disorders, and should select therapies from those agents that may have benefit in mood symptoms.…”

Section: Specific Populationsmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

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Section: Specific Populationsmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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“…In a case-control study of 972 patients from primary care practices, who had both diabetes and a new diagnosis of depression, those exposed to ACEIs in the last 6 months showed a lower odds ratio for depression (OR 1.3, 95% CI: 0.8–2.2) compared to those exposed to beta-blockers (BBs) (OR 2.6, 95% CI: 1.1–7.0) and calcium channel blockers (CCBs) (OR 2.2, 95% CI: 1.2–4.2) [ 201 ]. In a recent population cohort study, ACEIs decreased the incidence of MDD [ 202 ]. These results were replicated by Boal et al [ 203 ], who examined mood-related hospital admissions of 144,660 patients treated with antihypertensive monotherapy for a five-year follow-up.…”

Section: Clinical Datamentioning

confidence: 99%

The renin–angiotensin system: a possible new target for depression

Vian

Pereira

Chavarría

et al. 2017

BMC Med

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Depression remains a debilitating condition with an uncertain aetiology. Recently, attention has been given to the renin–angiotensin system. In the central nervous system, angiotensin II may be important in multiple pathways related to neurodevelopment and regulation of the stress response. Studies of drugs targeting the renin–angiotensin system have yielded promising results. Here, we review the potential beneficial effects of angiotensin blockers in depression and their mechanisms of action. Drugs blocking the angiotensin system have efficacy in several animal models of depression. While no randomised clinical trials were found, case reports and observational studies showed that angiotensin-converting enzyme inhibitors or angiotensin receptor blockers had positive effects on depression, whereas other antihypertensive agents did not. Drugs targeting the renin–angiotensin system act on inflammatory pathways implicated in depression. Both preclinical and clinical data suggest that these drugs possess antidepressant properties. In light of these results, angiotensin system-blocking agents offer new horizons in mood disorder treatment.

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“…That is why some studies were conducted to inhibit hypothalamicpituitaryadrenal axis activation [21]. Many researches results indicate a reduction in the symptoms of depression in hypertensive patients who have been treated with angiotensin converting enzyme inhibitors (ACEI) compared to those who have been treated with beta-blockers or calcium channel inhibitors [22,23]. Similar observations were made by Norwegians who observed on 55,472 patients using ACEI a significant reduction in depression symptoms compared to those using betablockers [24].…”

Section: Arbs -Angiotensin II Receptor Blockersmentioning

confidence: 86%

Psychiatric aspect of most common used cardiological drugs

Cholewa

Wysokińska

SIWEK

et al. 2020

J Educ Health Sport

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Introduction: The count of psychiatric patients is growing. The same trend it is observed among cardiovascular diseases and metabolic like diabetes. Many people take drugs which may affect on mental state. On the one hand that drugs could have pleotropic mechanism of action which are beginning to use in treatment of psychiatry. The other hand is showed undiscovered field of impact on brain working. Methods and Aim: Shown the psychiatric aspect, like side effects and unusual use, of the most used cardiological drugs. To do this, research of articles was done with the help of data bases such as PubMed and Google Scholar. Results: The most used cardiological drugs are beta blockers, calcium canal blockers, ACE inhibitors, ARBs, nitrates, cilostazol, amiodarone and clonidine In this article it was shown current known about those drugs like mechanism of action and a report of psychiatric clinical trials. Beta-blockers are the most commonly used group of cardiological drugs as the one that significantly affects mental health. Their therapeutic importance has been noted in diseases such as: PTSD or stage fright. It was also long believed that they could make depression worse, but the latest research strongly contradicts this. A positive effect in the treatment of depression can also be obtained by usage of inhibitors of the RAA. Calcium channel blockers are another group of cardiac drugs that are important in the regulation of mood in bipolar disorder. To sum up, a large proportion of cardiac drugs can influence the flow of psychiatric diseases, and the use of them may be clinically desirable in patients with bothcardiac and psychiatric problems.

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Angiotensin Converting Enzyme Inhibitors and Risk of Mood Disorders

Cited by 20 publications

References 9 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

The renin–angiotensin system: a possible new target for depression

Psychiatric aspect of most common used cardiological drugs

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