STANFORD, Calif. - The use of antidepressants in patients who have suffered a heart attack appears to reduce the risk of recurrent events and cardiac death, according to a large, multi-center study conducted by the National Heart, Lung and Blood Institute. The findings suggest that post-heart attack patients who suffer from depression should talk with their physicians about taking the medication.

"Our study provides much stronger evidence than we've ever had before that antidepressants are safe and may benefit these patients," said C. Barr Taylor, MD, professor of psychiatry and behavioral sciences at the Stanford University School of Medicine and lead author of the paper published in the July issue of Archives of General Psychiatry.

Cardiovascular disease, the leading cause of death, major morbidity and disability in the United States, is often linked with depression: according to past studies, 20 percent of patients with coronary heart disease suffer from major depression and 20 percent from minor depression. Studies have also shown that depression among post-heart attack patients is associated with death and recurrent heart attacks.

Researchers launched the ENRICHD (ENhancing Recovery In Coronary Heart Disease) study to determine whether cognitive behavioral therapy would impact mortality and morbidity in post-heart attack patients with depression. Following publication of their findings that cognitive therapy significantly reduced depression but had little effect on mortality rates, the researchers conducted a secondary analysis on the use of antidepressants among the study participants.

"Our initial results were published in JAMA, and there was some evidence that the participants on antidepressants had decreased morbidity and mortality," said Taylor. "Once we saw the effect we wanted to examine it more thoroughly."

The ENRICHD study, which is the largest psychotherapy trial in coronary patients to date, involved 1,834 dep
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Contact: Michelle Brandt
mbrandt@stanford.edu
650-723-0272
Stanford University Medical Center
4-Jul-2005

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