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Treating Depression May Reduce Risk of Heart Attack

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WebMD Health News

Oct. 15, 2001 -- Since their introduction a decade ago, the antidepressant medicines collectively called selective serotonin reuptake inhibitors (SSRIs) like Prozac and Zoloft have become some of the most widely prescribed drugs on the planet. Millions of people take SSRIs each day to combat symptoms of depression, and a new study suggests the antidepressants might be helping their hearts as well as their moods.

People taking SSRIs seemed to reduce their risk of heart attack by 65%, compared to those not taking the antidepressants, as both groups participated in a study conducted by researchers at the University of Pennsylvania. Previous studies have found a link between depression and heart disease. But this is the largest study to date to show a protective benefit from this class of antidepressants. The report was published Oct.16 in the journal Circulation: Journal of the American Heart Association.

Lead researcher Stephen E. Kimmel, MD, suggests the drugs might protect the heart in the same manner as aspirin: thinning the blood and preventing the formation of blood clots, which cause a heart attack.

But Kimmel tells WebMD that his study was too small and limited to allow more than an educated guess about how SSRIs work or even if they really do benefit the heart. All of the study participants were smokers and few took other types of antidepressants.

The researchers compared 653 randomly selected people who had experienced a heart attack with nearly 3,000 people with no history of heart problems. The study was designed to test the value of nicotine patches in preventing heart attacks, but data were also collected on antidepressant use.

After accounting for factors known to influence heart attack risk, the researchers concluded that people who took SSRIs for depression seemed to be protected from heart problems. Kimmel says, however, that the researchers cannot determine whether it was the antidepressants themselves that were so helpful or if treating the depression indirectly benefits the heart.

Cardiologist Lynn Smaha, MD, PhD, who is a past-president of the American Heart Association, agrees that larger and more precise studies are needed to determine SSRIs' effect on the heart.

Part of the story could indeed be what doctors have suspected -- that the drugs prevent formation of blood clots, Smaha tells WebMD. "But it could also be that people who are depressed are less likely to take care of themselves and more likely to engage in activities that are harmful to the heart. ... They may think, 'I'm too depressed to stop smoking or exercise.' People on antidepressants may just generally make better lifestyle choices."

Another possible result of this study, Smaha says, is that doctors may begin to study whether depression is more than a mental-health condition and can contribute to heart attacks as well.

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