An SSRI antidepressant is safe and effective for depressed, hospitalized heart patients

Of the 1 million Americans hospitalized each year for a heart attack, about 20 percent will also suffer from depression that puts them at triple the risk of dying. Yet most of these patients are not treated with antidepressants because older antidepressants were known to be cardiotoxic and the effects of the new antidepressants were unknown.

In the first study of an SSRI (selective serotonin reuptake inhibitor) antidepressant in 369 depressed patients recently hospitalized for heart attack, the drug sertraline (Zoloft) has been found to be safe and effective. In this limited-size trial, researchers also noted less life-threatening cardiac events in patients taking Zoloft compared with those on placebo, but the difference was not statistically significant.

The findings of the study, which took place at 40 medical centers throughout the world, will be published in the Aug. 14 issue of the Journal of the American Medical Association (JAMA). This landmark trial paves the way for a larger trial to determine if sertraline treatment reduces death and recurrent heart attack.

"Doctors have been afraid to prescribe antidepressants to heart patients," says Dr. Alexander Glassman, professor of clinical psychiatry at Columbia University College of Physicians & Surgeons and staff member at the New York State Psychiatric Institute, the paper's lead author and co-principal investigator. "But our results are very reassuring about the safety of sertraline. It's OK to go ahead and prescribe the drug to treat the depression." Dr. Christopher O'Connor, associate professor of cardiology at Duke University Medical Center, was the other co-principal investigator.

Although depressed patients are three times more likely to die after their first hospitalization for a heart attack than patients who are not depressed, doctors do not prescribe antidepressants to people with heart conditions. The older tricyclic drugs are dangerous for heart patients and, until

Contact: Leslie Boen
Columbia University Medical Center

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