Effect of SSRI and calcium channel blockers on depression symptoms and cognitive function in elderly persons treated for hypertension: three city cohort study

Tully, Phillip J.; Peters, Ruth; Pérès, Karine; Anstey, Kaarin J.; Tzourio, Christophe

doi:10.1017/s1041610217002903

Cited by 17 publications

(7 citation statements)

References 34 publications

(20 reference statements)

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“…Regarding mood disorders, CCB have been mainly explored for bipolar disorder and a cohort study found benefits for their use as an adjunctive therapy in the treatment of depression and associated cognitive dysfunction [36]. On the other hand, their use as monotherapy for hypertension was associated with increased hospitalisation for mood disorders [32].…”

Section: Discussionmentioning

confidence: 99%

The association of antihypertensive use and depressive symptoms in a large older population with hypertension living in Australia and the United States: a cross-sectional study

et al. 2020

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Section: Discussionmentioning

confidence: 99%

The association of antihypertensive use and depressive symptoms in a large older population with hypertension living in Australia and the United States: a cross-sectional study

et al. 2020

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“…187 Syst-Eur primarily had a calcium channel-blocker (CCB) based intervention, and showed reduction in dementia rates, 174 and the Perindopril Protection Against Recurrent Stroke Study (PROGRESS) showed a benefit in dementia reduction among individuals with a prior history of stroke or transient ischemic attack who were treated with active therapy (perindopril (an ACE inhibitor) or indapamide (a diuretic)) over 3.9 years, but only among individuals who also experienced recurrent stroke. 188 In the 3-City cohort study, participants who took a combination of selective serotonin reuptake inhibitors (SSRI's) with CCBs, compared with SSRI's combined with other antihypertensives, had improved cognitive performance, as well as improved depression scores, at 2-year followup, 189 with a similar beneficial effect on cognitive decline from CCBs noted in the Newcastle 85+ Study of elderly adults, without a similar benefit from other antihypertensives. 190 This is in direct contrast to findings from the Canadian Study of Health and Aging, in which Canadians aged 65 and older who took CCBs had steeper decline, measured by a modified mini-mental state examination repeated serially over 5 years, than did their counterparts who used other antihypertensive drugs (75% on CCBs declined, versus 59% on other antihypertensive drugs).…”

Section: Class-specific Effects Of Antihypertensive Drugsmentioning

confidence: 98%

Neurovascular and Cognitive Dysfunction in Hypertension

Iadecola

Gottesman

2019

Circulation Research

339

316

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Hypertension has emerged as a leading cause of age-related cognitive impairment. Long known to be associated with dementia caused by vascular factors, hypertension has more recently been linked also to Alzheimer's disease, the major cause of dementia in older people. Thus, while midlife hypertension is a risk factor for late-life dementia, hypertension may also promote the neurodegenerative pathology underlying Alzheimer's disease. The mechanistic bases of these harmful effects remain to be established. Hypertension is well known to alter in the structure and function of cerebral blood vessels, but how these cerebrovascular effects lead to cognitive impairment and promote Alzheimer disease pathology is not well understood. Furthermore, critical questions also concern whether treatment of hypertension prevents cognitive impairment, the blood pressure threshold for treatment, and the anti-hypertensive agents to be used. Recent advances in neurovascular biology, epidemiology, brain imaging, and biomarker development have started to provide new insights into these critical issues. In this review, we will examine the progress made to date and, after a critical evaluation of the evidence, we will highlight questions still outstanding and seek to provide a path forward for future studies.

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“…46 On the other hand, a recent study on elderly patients treated for hypertension found that the use of CCB along with selective serotonin reuptake inhibitor improves depression and cognitive decline seen in elderly patients. 47…”

Section: Discussionmentioning

confidence: 99%

Severe depressive symptoms in patients with hypertension: Are antihypertensive medications implicated?

Gammoh

Alqudah

shaikh

et al. 2023

Int J Psychiatry Med

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Objective This study examined whether antihypertensive medications and other patient characteristics are associated with severe depressive symptoms in a patient with hypertension. Methods Patients with a diagnosis of hypertension were recruited from the internal medicine outpatient clinics of a hospital in Amman, Jordan, into this cross-sectional study. Depression severity was assessed using the Patient Health Questionnaire-9 (PHQ-9); anxiety by the General Anxiety Disorder-7; sleep quality by the Insomnia Severity Index; and psychological stress by the Perceived Stress Scale. Multivariable binary logistic regression was used to examine the association between the different classes of antihypertensive medication and depressive symptoms. Results Of the 431 participants, 282 (65.4%) were men; 240 (55.7%) reported having type 2 diabetes; 359 (83.3%) had dyslipidemia; 142 (32.9%) were on beta-blockers; 197 (45.2%) were on ACE inhibitors or angiotensin receptor blockers; 203 (47.1%) were on metformin; and 133 (30.9%) were taking sulfonylurea. Severe depressive symptoms, indicated by scoring above the cut-off of 14 on the PHQ-9, was present in 165 (38.3%) patients. Severe depression was associated with younger age (<55 years) (OR = 3.15, 95% CI = 1.829-5.41, P < 0.001), unemployment (OR = 2.15, 95% CI = 1.15-4.00, P = 0.01), diabetes (OR = 1.81, 95% CI = 1.09-3.02, P = 0.02), severe anxiety (OR = 6.40, 95% CI = 3.64-11.28, P < 0.001), and severe insomnia (OR = 4.73, 95% CI = 2.85-7.82, P < 0.001). Conclusion Severe depressive symptoms were not associated with antihypertensive medications or other drugs used by hypertensive patients. Instead, age, diabetes, anxiety, and insomnia were the primary correlates of depression.

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Effect of SSRI and calcium channel blockers on depression symptoms and cognitive function in elderly persons treated for hypertension: three city cohort study

Abstract: The findings provide general population evidence that SSRI augmentation with CCB may improve depression and cognitive function.

Cited by 17 publications

References 34 publications

The association of antihypertensive use and depressive symptoms in a large older population with hypertension living in Australia and the United States: a cross-sectional study

The association of antihypertensive use and depressive symptoms in a large older population with hypertension living in Australia and the United States: a cross-sectional study

Neurovascular and Cognitive Dysfunction in Hypertension

Severe depressive symptoms in patients with hypertension: Are antihypertensive medications implicated?

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