Effects of antidepressant treatment following myocardial infarction
Open accessAbstract
Background: Depression following myocardial infarction is associated with poor cardiac prognosis. It is unclear whether antidepressant treatment improves long-term depression status and cardiac prognosis. Aims: To evaluate the effects of antidepressant treatment compared with usual care in an effectiveness study. Method: In a multicentre randomised controlled trial, 2177 myocardial infarction patients were evaluated for ICD–10 depression and randomised to intervention (n=209) or care as usual (n=122). Both arms were evaluated at 18 months post-myocardial infarction for long-term depression status and new cardiac events. Results: No differences were observed between intervention and control groups in mean scores on the Beck Depression Inventory (11.0, s.d.=7.5 v. 10.2, s.d.=5.l, P=0.45) or presence of ICD-10 depression (30.5 v. 32.1%, P=0.68). The cardiac event rate was 14% among the intervention group and 13% among controls (OR=1.07, 95% CI 0.57-2.00). Conclusions: Antidepressant treatment did not alter long-term depression post-myocardial infarction status or improve cardiac prognosis.
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In a randomized controlled trial, a flexible 6-month depression management intervention offering several medication and nonmedication options in 331 cardiac patients was not associated with lower risk of cardiovascular events or all-cause mortality 8 years later compared with usual care.
“In a randomized controlled trial, a flexible 6-month depression management intervention offering several medication and nonmedication options in 331 cardiac patients similarly was not associated with lower risk of cardiovascular events or all-cause mortality 8 years later compared with usual care. 193,194”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [194]
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Experimental — accuracy not yet measuredMost studies showed no significant beneficial effect of treating depression on cardiac endpoints, but a recent RCT revealed fewer depressive symptoms and fewer major adverse cardiac events.
“Whereas most studies could show no significant beneficial effect, 84,351 -356 a recent RCT revealed fewer depressive symptoms as well as fewer major adverse cardiac events.85”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [355]
Coronary patients with clinically significant depression can be safely and effectively treated with psychotherapy or SSRIs, but evidence for a beneficial effect on cardiac endpoints is inconclusive.
“Coronary patients with clinically significant depression can be safely and effectively treated with psychotherapy 84,85,351 -353 or selective serotonin re-uptake inhibitors, 354 -356 although evidence for a beneficial effect on cardiac endpoints is inconclusive.”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [355]
A systematic review of 12 RCTs (929 participants) reports no evidence of efficacy for monotherapy with an antidepressant or an antipsychotic, but superior efficacy of their combination over either monotherapy alone or placebo for depression with psychotic features.
“A systematic review of 12 RCTs (929 participants) reports no evidence of efficacy for monotherapy with an antidepressant or an antipsychotic, but superior efficacy of their combination over either monotherapy alone or placebo. 541”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [541]
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- Authors
- van Melle, J. P., de Jonge, P., Honig, A., Schene, A. H., Kuyper, A. M. G., Crijns, H. J. G. M., Schins, A., Tulner, D., van den Berg, M. P., & Ormel, J.
- Affiliations
- Sint Lucas Andreas Hospital (NL)
- Maastricht University Medical Centre (NL)
- Medisch Centrum Leeuwarden (NL)
- University Medical Center Groningen (NL)
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2007-06
- Volume
- 190
- Issue
- 6
- Pages
- 460-466
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2151352724
- Cited by
- 324
- References
- 37
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 4 · 2023: 5 · 2022: 5 · 2021: 7 · 2020: 47 · 2019: 6 · 2018: 14 · 2017: 15 · 2016: 7 · 2015: 22 · 2014: 9 · 2013: 29 · 2012: 29
- FWCI
- 18.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- antidepressants, myocardial infarction, post-myocardial infarction depression, cardiac prognosis, cardiac events, depression treatment, cardiac rehabilitation
- MeSH terms
- Aged, Antidepressive Agents, Depressive Disorder, Female, Follow-Up Studies, Health Status, Humans, Male, Middle Aged, Myocardial Infarction, Prognosis, Psychiatric Status Rating Scales, Quality of Life, Risk, Treatment Outcome
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