Pharmacotherapy of the depressed patient with cardiovascular and/or cerebrovascular illness.
Cardiovascular and cerebrovascular disease are associated with a high incidence of depressive disorder. Despite this high level of co-morbidity, depressive disorders appear to go largely unrecognised and remain untreated. This may have serious consequences, as concomitant depression worsens the prognosis in patients with cardiovascular or cerebrovascular disease, increases medical costs, and delays return to work. Treatment with traditional tricyclic antidepressants is difficult in these patients because of the known cardiac effects. The favourable side-effect profiles of the 5-HT reuptake inhibitors suggest that they may offer therapeutic advantages, as they have little or no effect on cardiac conduction, do not cause orthostatic hypotension, and lack serious sequelae in overdose. The pharmacological profiles and the reduced potential of these newer antidepressant drugs to cause drug interaction show important differences that may be of clinical relevance in this patient population.
Lane
R M
RM
International Pharmaceuticals Group, Pfizer Inc, New York 10017-5755.
Sweeney
M
M
Henry
J A
JA
D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000150:complications*; D002561:Cerebrovascular Disorders / Q000150:complications*; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy*; D004347:Drug Interactions; D006801:Humans; D008803:Mianserin / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D014196:Trazodone / Q000627:therapeutic use
D000929:Antidepressive Agents, Tricyclic; D002317:Cardiovascular Agents; D008803:Mianserin; D017367:Selective Serotonin Reuptake Inhibitors; D014196:Trazodone