Treatment of post-myocardial infarction depressive disorder.
Both major and minor depressive disorder post-myocardial infarction (MI) are associated with an increased risk of all-cause mortality, cardiac mortality and new cardiovascular events. Post-MI depressive disorder predicts slow recovery and poor quality of life. This review attends to post-MI depressive disorder, its underlying mechanisms and options for and effects of treatment. Evidence has been found for several mechanisms to be involved in the pathophysiology, including hypothalamus-pituitary-adrenal axis activity, immune activity, polyunsaturated fatty acids, serotonin, platelet activation, type D personality and negative health behavior. Five leading randomized controlled trials are discussed, showing safety and efficacy of antidepressive treatment in post-MI patients. Effects on cardiac outcome remain unclear.
Kuyper
Astrid M G
AM
Department of Psychiatry, Academic Medical Center Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. a.m.g.kuyper@chello.nl
Honig
Adriaan
A
D003866:Depressive Disorder / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy