Digitalis and beta-blocking agents: effects on depression following myocardial infarction.
Depression is frequently seen in patients following myocardial infarction (MI), many of whom are receiving digitalis glycosides, beta-blockers, or other agents that may exert central nervous system (CNS) effects. In a prospective study of the clinical significance of post-MI depression, 335 patients were assessed using a standardized diagnostic interview for depression at 8 to 10 days, and 190 were reinterviewed at 3 to 4 months. Patients prescribed digitalis, beta-blockers, or other cardioactive medications at hospital discharge were identified. Logistic regression analyses were performed to determine the contribution of these agents to depression at 3 to 4 months, controlling for medical and sociodemographic factors as well as for baseline depression. Treatment with digitalis predicted depression at 3 to 4 months (p less than 0.05); no other medications, including beta-blockers, predicted depression (p greater than 0.10). Digitalis may have CNS effects that contribute to depression post-MI and this finding should be considered in the differential diagnosis of depression in cardiac patients.
Schleifer
S J
SJ
Department of Medicine, Mount Sinai School of Medicine City University of New York.
Slater
W R
WR
Macari-Hinson
M M
MM
Coyle
D A
DA
Kahn
M
M
Zucker
H D
HD
Gorlin
R
R
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D003866:Depressive Disorder / Q000139:chemically induced* / Q000453:epidemiology; D004071:Digitalis Glycosides / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000523:psychology*; D011446:Prospective Studies; D012044:Regression Analysis; D013997:Time Factors
D000319:Adrenergic beta-Antagonists; D004071:Digitalis Glycosides