Antidepressant drugs and the cardiovascular system: a comparison of tricylics and selective serotonin reuptake inhibitors and their relevance for the treatment of psychiatric patients with cardiovascular problems

Coupland, Nicholas J.; Wilson, Susan J.; Nutt, David

doi:10.1177/026988119701100118

Cited by 34 publications

(27 citation statements)

References 97 publications

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“…Depression has been revealed to be an independent risk factor for the future onset, progression, and recurrence of CVD (Carney et al, 1988;Ferketich et al, 2000;Nicholson et al, 2006;Rugulies 2002;Sesso et al, 1998;Wassertheil-Smoller et al, 2004), which can be mediated both by poor health behavior and by the pathophysiological correlates of depressive symptoms, e.g., neuroendocrine and inflammatory activation (Frasure-Smith and Lesperance, 2010;Rozanski et al, 2005). Additionally, individual antidepressants have a wide range of cardiovascular effects which may affect cardiovascular-related morbidity and mortality (Coupland et al, 1997;Taylor 2008;Vieweg and Wood, 2004); it seems likely that the co-existence of CVD and depression may impact patients' physical conditions and their non-psychiatric costs.…”

Section: Comorbid Cardiovascular Diseasementioning

confidence: 99%

Treatment costs for depression with pain and cardiovascular comorbidities

Pan

Knapp

Yeh

et al. 2013

Journal of Psychiatric Research

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Objective: As depressive disorders are highly heterogeneous, and as patients exhibit wide differences in clinical characteristics and comorbidities, we aim to examine whether and how demographic and clinical correlates affect healthcare costs for patients with depression in a real-world setting. Method: A national cohort of adult patients (n=216,557) who received treatment for depression was identified from the National Health Insurance Research Database in Taiwan. Factors associated with service use and healthcare costs over a 12-month period were explored, with a particular focus on past treatment history, comorbid physical illnesses, painful physical symptoms, and choice of initial antidepressants. Results: Depression severity, past treatment history, comorbid mental/physical illnesses, painful physical symptoms, and choice of initial antidepressants were found to be associated with healthcare costs in the following year, although the nature of the associations differed across cost categories. The presence of comorbid cardiovascular disease or certain painful physical symptoms at baseline was associated not only with higher non-psychiatric but also with higher psychiatric costs; moreover, patients with these comorbidities were shown to have increased use of psychiatric emergency and inpatient services. Conclusion: Healthcare costs for depression are affected by a number of clinical characteristics and comorbidities of patients. The importance of comorbid pain and cardiovascular conditions warrants further research.

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Section: Comorbid Cardiovascular Diseasementioning

confidence: 99%

Treatment costs for depression with pain and cardiovascular comorbidities

Pan

Knapp

Yeh

et al. 2013

Journal of Psychiatric Research

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“…There are reports of severe bradycardia (fluoxetine plus beta blockers), increased effects of digitalis (paroxetine), increased QTc interval as well as severe bradycardia in combination with other cardiac drugs (paroxetine), enhanced concentration of beta blockers (paroxetine, fluvoxamine) and amplification of calcium antagonists (fluoxetine) [81,102,109,110]. Furthermore, the high anticholinergic effect (m3 receptor binding) of paroxetine -a potent inhibitor of nitrogen oxide (NO) synthetase, which is cardioprotectivemust be kept in mind, also being partly responsible to withdrawal effects [111].…”

Section: Selective Serotonin Reuptake Inhibitors (Ssris)mentioning

confidence: 99%

“…SSRIs can induce a distinct reduction of serotonin in platelets [102]. In depressed patients with or without IHD, paroxetine led to decreased platelet activation and aggregation compared to [101], increased QT variability [50] Ventricular arrhythmias, fibrillation, and heart block when overdosed [50] Decrease of all HRV components [41] Tachycardia [50,102] Increase of sudden cardiac death in patients with ischemic heart disease [50] No influence on myocardial contractility [ With careful indication only Increased QTc interval [81] non-depressed controls [113,114]. Still, these antiplatelet effects of SSRIs were not related to antidepressant actions.…”

Section: Selective Serotonin Reuptake Inhibitors (Ssris)mentioning

confidence: 99%

High impact of depression in heart failure: Early diagnosis and treatment options

Norra¹,

Skobel²,

Arndt³

et al. 2008

International Journal of Cardiology

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“…Treatment with this drug in the acute phase (Rivarola et al 2001(Rivarola et al , 2005 clearly prevented the electrical damage of the heart. Even though clomipramine and other antidepressant drugs are known to prolong the electrical heart conduction, provoking reversible changes in the QT segment (Coupland et al 1997), these side effects were not detected in our results because the electrocardiographic studies were performed 50 days after the end of the treatment and none of the animals died during clomipramine administration.…”

Section: Discussionmentioning

confidence: 60%

Chemotherapy of chronic indeterminate Chagas disease: a novel approach to treatment

et al. 2008

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Treatment of Chagas disease is a controversial issue because the available drugs are highly toxic. Clomipramine is a tricyclic antidepressant drug that inhibits Trypanosoma cruzi's trypanothione reductase, provoking the death of the parasite and preventing the cardiac damage when used for the treatment of acutely infected mice. Here, we studied the effectiveness of clomipramine (5 mg/kg/day for one month) as chemotherapy for T. cruzi-infected mice in the chronic indeterminate stage of the infection. The animals were analyzed in the cardiac chronic phase. Survival of treated animals was 84% while for the untreated ones was 40%; most of the animals presented electrocardiographic abnormalities. Affinity and density of cardiac beta receptors from infected and treated mice were similar to those in the indeterminate phase, showing that clomipramine treatment stopped the increment of functional alterations provoked by the infection, while untreated mice presented affinity and density significantly diminished. Hearts from infected and untreated mice in the chronic stage presented mononuclear cells, necrosis and fiber dissolution while hearts from treated animals showed only isolated inflammatory infiltrates. Present results demonstrate that clomipramine used in the chronic indeterminate phase of the T. cruzi infection modified the natural evolution of the chagasic cardiopathy.

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Antidepressant drugs and the cardiovascular system: a comparison of tricylics and selective serotonin reuptake inhibitors and their relevance for the treatment of psychiatric patients with cardiovascular problems

Cited by 34 publications

References 97 publications

Treatment costs for depression with pain and cardiovascular comorbidities

Treatment costs for depression with pain and cardiovascular comorbidities

High impact of depression in heart failure: Early diagnosis and treatment options

Chemotherapy of chronic indeterminate Chagas disease: a novel approach to treatment

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