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Cited by 85Cardiac Health and Mental HealthTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

TREATMENT OF DEPRESSION IN CARDIOVASCULAR DISEASE: Review: Treatment of depression in cardiovascular disease

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Mavrides, Nicole, Nemeroff, Charles·2013·Depression and Anxiety
DOI 10.1002/da.22051
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Abstract

BACKGROUND AND OBJECTIVES: Depression in patients with Cardiovascular Disease (CVD) is extremely common, with a prevalence of 17-47%, and is associated with increased risk of morbidity and mortality. Treatment of depression has been hypothesized to reduce cardiac mortality. Pharmacologic and psychotherapeutic interventions have been studied and appear to be safe and in some studies effective in reducing depressive symptoms in patients with cardiac disease. The impact on cardiac outcomes remains unclear. This review briefly focuses on the prevalence of depression in patients with CVD, the physiological links between depression and CVD, and largely is concerned with the clinical trials that seek to demonstrate efficacy and safety of antidepressant medications and psychotherapy in this patient population. METHODS: PubMed and PsycINFO databases were searched through July 2012. Publications were included if they were in English, a review article, or a clinical trial in the CVD population with comorbid depression. The search was completed with key words of antidepressants, CVD, coronary artery syndrome, SSRIs, depression, treatment of depression, post-MI (where MI is myocardial infarction), major depression, and cardiac disease. Trials were included if the patients were above the age of 18, both male and female genders, and had cardiac comorbidity. No trials were excluded. RESULTS: A total of 61 articles and/or book chapters were included. The majority were from North America and Europe. There were 7 clinical trials of tricyclic antidepressants (TCAs), one of TCAs and bupropion, and 10 trials of selective serotonin reuptake inhibitors (SSRIs). We also evaluated five trials involving psychotherapeutic techniques and/or collaborative care. CONCLUSIONS: There is considerable evidence from randomized controlled clinical trials that antidepressants, especially SSRIs, are safe in the treatment of major depression in patients with CVD. Although efficacy has been demonstrated in some, but not all, trials for both antidepressants and certain psychotherapies, large, well-powered trials are urgently needed. There are virtually no data available on predictors of antidepressant response in depressed patients with CVD. Whether successful treatment of depression is associated with a reduction in cardiac morbidity and mortality remains unknown.

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  • There is Level 2 Evidence for treatment of depression with co-occurring cardiovascular disease for CBT, interpersonal therapy (IPT), and problem-solving therapy (PST).

    “there is Level 2 Evidence for treatment of depression with co-occurring cardiovascular disease for CBT, interpersonal therapy (IPT), and problem-solving therapy (PST).25,[27][28][29]”

    From Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder (2016) · cites this paper as [28]

    The Psychotherapeutic Interventions section reports improved depression scores for a problem-solving-therapy intervention that could also include medication, and the Discussion reports a positive CBT trial. But the Discussion says psychotherapy trial results were mixed and IPT showed no additional benefit over usual care. The paper does not assign these therapies a “Level 2 Evidence” rating. Page numbers are unavailable in our copy. (LLM, conf=0.87)

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Research works printed but not linked: 4

  1. [14]14. Cowles MK, Musselman DL, McDonald W, Nemeroff CB. Ef- fects of mood and anxiety disorders on the cardiovascular system. In: Fuster V, Walsh R, Harrington R, editors. Hurst's the Heart, 13th edition, Chapter 96. New York: McGraw-Hill Publishers; 2010:2128-2145.
  2. [36]36. Depression and Anxiety 15206394, 2013, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/da.22051 by Mount Vernon Nazarene University, Wiley Online Library on [28/08/2026]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
  3. [45]45. Shapiro PA, Lesperance F, Frasure-Smith N. An open-label pre- liminary trial of sertraline for treatment of major depression af- ter acute myocardial infarction (SAHDAT trial). Sertraline Anti- Depressant Heart Attack Trial. Am Heart J 1999;37:1100-1106.
  4. [60]60. Freedland KE, Skala JA, Carney RM, et al. Treatment of depres- sion after coronary artery bypass surgery. Arch Gen Psychiatry 2009;66(4):387-396.

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Authors
Mavrides, N., & Nemeroff, C.
Affiliations
University of Miami (US)
Corresponding author
Nemeroff, Charles
ORCID
Nemeroff, Charles
Venue
Depression and Anxiety
Publisher
Hindawi Limited
Published
2013-01-04
Volume
30
Issue
4
Pages
328-341
ISSN
1091-4269 (ISSN-L)
DOI
10.1002/da.22051
OpenAlex
W1892640469
Semantic Scholar
1d0582948fa9189d138ad6ac40e86b7c74738314
Cited by
85
References
68
Citations by year
2026: 4 · 2025: 3 · 2024: 1 · 2023: 7 · 2022: 8 · 2021: 1 · 2020: 3 · 2018: 7 · 2017: 15 · 2016: 12 · 2015: 10 · 2014: 4 · 2013: 10
FWCI
2.05
Type
journal article
Language
en
Open access
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 970 d)
Locations
  • Depression and Anxiety (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • Agency for Healthcare Research and Quality
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
depression, cardiovascular disease, antidepressants, selective serotonin reuptake inhibitors, tricyclic antidepressants, bupropion, psychotherapy, collaborative care, major depressive disorder, myocardial infarction, cardiac mortality, comorbidities, depression prevalence
MeSH terms
Antidepressive Agents, Cardiovascular Diseases, Major Depressive Disorder, Female, Humans, Male, Psychotherapy, Treatment Outcome

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