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The safety of tricyclic antidepressants in cardiac patients: risk-benefit reconsidered

Article Abstract:

Tricyclic antidepressants (TCAs) may cause life-threatening side effects in patients with ischemic heart disease. TCAs are a group of drugs used to treat mental depression. They also suppress arrhythmias, or an irregular heart beat. A research study found that patients treated with flecainide, encainide or moricizine had a higher risk of early death than those treated with a placebo, or an inactive substance. Flecainide, encainide and moricizine are three antiarrhythmia drugs. The antiarrhythmic effect of TCAs is similar to that of moricizine. Antidepressant drugs are often prescribed to depressed patients with asymptomatic arrhythmia with or without ischemic heart disease. Physicians should be careful in prescribing TCAs to depressed patients with ventricular arrhythmia after a heart attack. Other antidepressants may also have an adverse effect on the cardiovascular system.

Author: Roose, Steven P., Glassman, Alexander H., Bigger, J. Thomas, Jr.
Publisher: American Medical Association
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1993
Care and treatment, Column, Complications and side effects, Cardiac patients, Antidepressants, Tricyclic, Tricyclic antidepressants

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Comparison of paroxetine and nortriptyline in depressed patients with ischemic heart disease

Article Abstract:

Paroxetine may effectively treat depression with fewer adverse cardiac events than nortriptyline in patients with ischemic heart disease. Depression increases the risk of death after heart attacks, but antidepressant drugs may produce undesirable cardiac side effects. Researchers compared paroxetine and nortriptyline for six weeks in 81 patients with ischemic heart disease. Both drugs were effective against depression, but adverse cardiac events occurred in 2% of those taking paroxetine and 18% of those taking nortriptyline.

Author: Roose, Steven P., Nelson, J. Craig, Gergel, Ivan, Pollock, Bruce G., Laghrissi-Thode, Fouzia, Kennedy, John S., Bigger, J. Thomas, Gaffney, Andrew, Narayan, Meena, Finkel, Mitchell S., McCafferty, James
Publisher: American Medical Association
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1998
Evaluation, Heart, Paroxetine, Nortriptyline

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Relationship Between Depression and Other Medical Illnesses

Article Abstract:

People with a chronic disease who are also depressed have higher mortality rates than those without depression. For this reason, it is always appropriate to treat depression in people with a chronic disease.

Author: Roose, Steven P., Glassman, Alexander H., Seidman, Stuart N.
Publisher: American Medical Association
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 2001
Health aspects, Patient outcomes, Mortality, Coronary heart disease, Stroke (Disease), Stroke

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Subjects list: Drug therapy, Depression, Mental, Depression (Mood disorder)
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