title: Selective serotonin reuptake inhibitors and endothelial function in women.
abstract: BACKGROUND
  Among women worldwide, major depression (MDD) and heart disease rank first and second, respectively, in burden of disease. Although selective serotonin reuptake inhibitors (SSRIs) are frequently prescribed, possible inhibition of nitric oxide (NO) function has caused concerns about their effects on protective vascular mechanisms. Our study aimed to determine the effect of SSRIs on flow-mediated vascular dilatation (FMD), platelet aggregation, and platelet NO production among women.
  
  
  METHODS
  Women (n=28) without known cardiovascular disease were recruited prior to undergoing SSRI treatment for MDD, postpartum depression (PPD), or premenstrual dysphoric disorder (PMDD). Symptoms were quantified using the Hamilton Depression/Anxiety and Beck Depression scales. FMD, platelet aggregation, and platelet NO production were measured before and after 1 month of SSRI (sertraline, fluoxetine, or paroxetine) therapy.
  
  
  RESULTS
  Depression and anxiety symptoms decreased significantly with SSRI treatment (ps <0.01). FMD and platelet aggregation did not differ between pre- and posttreatment, although FMD rose to the normal range (≥ 8%) in two of three women with abnormal FMD prior to SSRI treatment. We observed a 21% decrease (p=0.024) in platelet NO production.
  
  
  CONCLUSIONS
  SSRI treatment had little effect on FMD or platelet aggregation. The health impact of decreased NO production is unclear, particularly in this relatively young group of women without cardiovascular disease, but should be considered in future studies focusing on SSRI safety in patients with cardiovascular disease.
authors.affiliation: 1 Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Liisa
authors.initials: L
authors.lastname: Hantsoo
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Czarkowski
authors.forename: Josiah
authors.initials: J
authors.lastname: Child
authors.forename: Christopher
authors.initials: C
authors.lastname: Howes
authors.forename: C Neill
authors.initials: CN
authors.lastname: Epperson
mesh_terms: D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000000981:diagnostic imaging; D019052:Depression, Postpartum / Q000188:drug therapy* / Q000523:psychology; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009569:Nitric Oxide / Q000502:physiology; D010974:Platelet Aggregation / Q000187:drug effects*; D011293:Premenstrual Syndrome / Q000188:drug therapy* / Q000523:psychology; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014664:Vasodilation / Q000502:physiology; D055815:Young Adult
chemical_list: D009569:Nitric Oxide; D017367:Selective Serotonin Reuptake Inhibitors