Antidepressant May Prevent Blood Clots
Treating Depression Along With Heart Disease May Lower Risks
Aug. 11, 2003 -- Treating the depression that often accompanies
heart disease with an antidepressant may not only help people feel better, but
it may also reduce their risk of future heart attacks.
A new study shows adding an antidepressant to traditional heart
disease therapy after a heart attack or chest pain can reduce the chances of
dangerous blood clots that can lead to a heart attack.
The results appear in the current issue of Circulation:
Journal of the American Heart Association.
Researchers say depression is common in people with heart
disease, and as many as one in four people develop depression after a heart
attack. Although recent studies have shown that depression raises the risk of
death due to heart disease, researchers say depression often goes untreated in
heart patients because many doctors are reluctant to prescribe certain types of
antidepressants that might make their heart disease worse.
SSRIs May Lower Clotting Risks
But researchers say the newer class of antidepressants known as
SSRIs (selective serotonin reuptake inhibitors) don't carry the same heart
risks as older types of antidepressants and may actually help prevent blood
SSRIs work by blocking the reuptake of the chemical serotonin
in the brain and in the blood, where it is absorbed by platelets involved in
the clotting process.
In the study, researchers measured eight factors related to
blood clotting in 64 men and women who were diagnosed with depression after
being hospitalized for a heart attack or chest pain. All of the participants
were also receiving other anticlotting medications such as aspirin to reduce
the risk of a future heart attack, and 28 of them also received the
"To prevent clotting after a coronary event, it is routine
for patients to be treated with anti-coagulants and anti-platelet drugs. This
study looked at whether adding [Zoloft] to these standard treatments provided
an additional benefit," says researcher Christopher M. O'Connor, MD,
professor of medicine and director of the heart failure program at Duke
University Medical Center, in a news release.
In measurements taken six and 16 weeks after treatment began,
the study showed that patients who took an antidepressant in addition to
standard heart disease medications had lower platelet activity in 12 of the 16
measurements compared with only eight of 16 in the other group.
Researchers also found that adding Zoloft to the traditional
therapies did not increase the risk of bleeding associated with older
"Down the road, the big question is whether [Zoloft] might
be a beneficial cardiovascular drug, used not just to treat cardiac patients
with major depression but to reduce cardiac risk in those with mild depression
or no depression," says O'Connor.