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 clots.
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 antidepressant Zoloft.
"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 antidepressants.
"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.