Antidepressants and cardiovascular adverse events: A narrative review
<div><p><strong>BACKGROUND:</strong> Major depression or deterioration of previous mood disorders is a common adverse consequence of coronary heart disease, heart failure, and cardiac revascularization procedures. Therefore, treatment of depression is expected to result in im...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Vesnu Publications
2015-09-01
|
| Series: | ARYA Atherosclerosis |
| Subjects: | |
| Online Access: | http://arya.mui.ac.ir/index.php/arya/article/view/1191 |
| _version_ | 1828903090079662080 |
|---|---|
| author | Mohammad Hassan Nezafati Mohammad Vojdanparast Pouya Nezafati |
| author_facet | Mohammad Hassan Nezafati Mohammad Vojdanparast Pouya Nezafati |
| author_sort | Mohammad Hassan Nezafati |
| collection | DOAJ |
| description | <div><p><strong>BACKGROUND:</strong> Major depression or deterioration of previous mood disorders is a common adverse consequence of coronary heart disease, heart failure, and cardiac revascularization procedures. Therefore, treatment of depression is expected to result in improvement of mood condition in these patients. Despite demonstrated effects of anti-depressive treatment in heart disease patients, the use of some antidepressants have shown to be associated with some adverse cardiac and non-cardiac events. In this narrative review, the authors aimed to first assess the findings of published studies on beneficial and also harmful effects of different types of antidepressants used in patients with heart diseases. Finally, a new categorization for selecting antidepressants according to their cardiovascular effects was described.</p> <p><strong>METHODS:</strong> Using PubMed, Web of Science, SCOPUS, Index Copernicus, CINAHL, and Cochrane Database, we identified studies designed to evaluate the effects of depression and also using antidepressants on cardiovascular outcome. A 40 studies were finally assessed systematically. Among those eligible studies, 14 were cohort or historical cohort studies, 15 were randomized clinical trial, 4 were retrospective were case-control studies, 3 were meta-analyses and 2 animal studies, and 2 case studies.</p> <p><strong>RESULTS:</strong><strong> </strong>According to the current review, we recommend to divide antidepressants into three categories based on the severity of cardiovascular adverse consequences including (1) the safest drugs including those drugs with cardio-protective effects on ventricular function, as well as cardiac conductive system including selective serotonin reuptake inhibitors, (2) neutralized drugs with no evidenced effects on cardiovascular system including serotonin–norepinephrine reuptake inhibitors, and (3) harmful drugs with adverse effects on cardiac function, hemodynamic stability, and heart rate variability including tricyclic antidepressants, serotonin antagonist and reuptake inhibitors, and noradrenergic and specific serotonergic antidepressants.</p> <p><strong>CONCLUSION:</strong> The presented categorization of antidepressants can be clinically helpful to have the best selection for antidepressants to minimizing their cardiovascular harmful effects.</p> <p> </p></div><p> </p> |
| first_indexed | 2024-12-13T16:27:12Z |
| format | Article |
| id | doaj.art-9eb3069cf84645f0841ac89bf7d695fb |
| institution | Directory Open Access Journal |
| issn | 1735-3955 2251-6638 |
| language | English |
| last_indexed | 2024-12-13T16:27:12Z |
| publishDate | 2015-09-01 |
| publisher | Vesnu Publications |
| record_format | Article |
| series | ARYA Atherosclerosis |
| spelling | doaj.art-9eb3069cf84645f0841ac89bf7d695fb2022-12-21T23:38:34ZengVesnu PublicationsARYA Atherosclerosis1735-39552251-66382015-09-01115295304551Antidepressants and cardiovascular adverse events: A narrative reviewMohammad Hassan Nezafati0Mohammad Vojdanparast1Pouya Nezafati2Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, IranAtherosclerosis Prevention Research Center AND School of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Cardiac Surgery, Imam Reza Hospital, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran<div><p><strong>BACKGROUND:</strong> Major depression or deterioration of previous mood disorders is a common adverse consequence of coronary heart disease, heart failure, and cardiac revascularization procedures. Therefore, treatment of depression is expected to result in improvement of mood condition in these patients. Despite demonstrated effects of anti-depressive treatment in heart disease patients, the use of some antidepressants have shown to be associated with some adverse cardiac and non-cardiac events. In this narrative review, the authors aimed to first assess the findings of published studies on beneficial and also harmful effects of different types of antidepressants used in patients with heart diseases. Finally, a new categorization for selecting antidepressants according to their cardiovascular effects was described.</p> <p><strong>METHODS:</strong> Using PubMed, Web of Science, SCOPUS, Index Copernicus, CINAHL, and Cochrane Database, we identified studies designed to evaluate the effects of depression and also using antidepressants on cardiovascular outcome. A 40 studies were finally assessed systematically. Among those eligible studies, 14 were cohort or historical cohort studies, 15 were randomized clinical trial, 4 were retrospective were case-control studies, 3 were meta-analyses and 2 animal studies, and 2 case studies.</p> <p><strong>RESULTS:</strong><strong> </strong>According to the current review, we recommend to divide antidepressants into three categories based on the severity of cardiovascular adverse consequences including (1) the safest drugs including those drugs with cardio-protective effects on ventricular function, as well as cardiac conductive system including selective serotonin reuptake inhibitors, (2) neutralized drugs with no evidenced effects on cardiovascular system including serotonin–norepinephrine reuptake inhibitors, and (3) harmful drugs with adverse effects on cardiac function, hemodynamic stability, and heart rate variability including tricyclic antidepressants, serotonin antagonist and reuptake inhibitors, and noradrenergic and specific serotonergic antidepressants.</p> <p><strong>CONCLUSION:</strong> The presented categorization of antidepressants can be clinically helpful to have the best selection for antidepressants to minimizing their cardiovascular harmful effects.</p> <p> </p></div><p> </p>http://arya.mui.ac.ir/index.php/arya/article/view/1191Selective Serotonin Reuptake Inhibitors, Tricyclic Antidepressant, Antidepressants, Review |
| spellingShingle | Mohammad Hassan Nezafati Mohammad Vojdanparast Pouya Nezafati Antidepressants and cardiovascular adverse events: A narrative review ARYA Atherosclerosis Selective Serotonin Reuptake Inhibitors, Tricyclic Antidepressant, Antidepressants, Review |
| title | Antidepressants and cardiovascular adverse events: A narrative review |
| title_full | Antidepressants and cardiovascular adverse events: A narrative review |
| title_fullStr | Antidepressants and cardiovascular adverse events: A narrative review |
| title_full_unstemmed | Antidepressants and cardiovascular adverse events: A narrative review |
| title_short | Antidepressants and cardiovascular adverse events: A narrative review |
| title_sort | antidepressants and cardiovascular adverse events a narrative review |
| topic | Selective Serotonin Reuptake Inhibitors, Tricyclic Antidepressant, Antidepressants, Review |
| url | http://arya.mui.ac.ir/index.php/arya/article/view/1191 |
| work_keys_str_mv | AT mohammadhassannezafati antidepressantsandcardiovascularadverseeventsanarrativereview AT mohammadvojdanparast antidepressantsandcardiovascularadverseeventsanarrativereview AT pouyanezafati antidepressantsandcardiovascularadverseeventsanarrativereview |