Document Detail


Cardiovascular mechanisms of SSRI drugs and their benefits and risks in ischemic heart disease and heart failure.
MedLine Citation:
PMID:  23325305     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Depression and heart disease are commonly comorbid. Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat depression. In March 2011, we carried out a 15-year search of PubMed for preclinical and clinical publications related to SSRIs and ischemic heart disease (IHD) or congestive heart failure (CHF). We identify and discuss a number of mechanisms by which SSRIs may influence cardiovascular functioning and health outcomes in patients with heart disease; many of the mechanisms that we present have received little attention in previous reviews. We examine studies with positive, neutral, and negative outcomes in IHD and CHF patients treated with SSRIs. SSRIs influence cardiovascular functioning and health through several different mechanisms; for example, they inhibit serotonin-mediated and collagen-mediated platelet aggregation, reduce inflammatory mediator levels, and improve endothelial function. SSRIs improve indices of ventricular functioning in IHD and heart failure without adversely affecting electrocardiographic parameters. SSRIs may also be involved in favorable or unfavorable drug interactions with medications that influence cardiovascular functions. The clinical evidence suggests that, in general, SSRIs are safe in patients with IHD and may, in fact, exert a cardioprotective effect. The clinical data are less clear in patients with heart failure, and the evidence for benefits with SSRIs is weak.
Authors:
Andrade Chittaranjan; Kumar B Chethan; Surya Sandarsh
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  International clinical psychopharmacology     Volume:  28     ISSN:  1473-5857     ISO Abbreviation:  Int Clin Psychopharmacol     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-03-25     Completed Date:  2013-12-23     Revised Date:  2014-01-16    
Medline Journal Info:
Nlm Unique ID:  8609061     Medline TA:  Int Clin Psychopharmacol     Country:  England    
Other Details:
Languages:  eng     Pagination:  145-55     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure / drug effects*,  physiology
Heart Failure / drug therapy*,  epidemiology
Heart Rate / drug effects*,  physiology
Humans
Myocardial Ischemia / drug therapy*,  epidemiology
Risk Assessment
Serotonin Uptake Inhibitors / adverse effects,  pharmacology,  therapeutic use*
Chemical
Reg. No./Substance:
0/Serotonin Uptake Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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