Association between common cardiovascular drugs and depression

Tao, Shuhui; Ren, Xuequn; Zhang, Lijun

doi:10.1097/cm9.0000000000001875

Cited by 15 publications

(27 citation statements)

References 81 publications

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“…In addition to the regulation of blood pressure, the RAS is also an important regulator of the inflammatory states in the nervous system ( 94 ). Excessively elevated Ang II levels enhance plasma cytokine levels such as IL-6, interferon-γ (IFN-γ), TNF-α, and IL-1β ( 95 ).…”

Section: Potential Mechanisms Of Ras Blockers-induced Antidepressant/...mentioning

confidence: 99%

Renin-angiotensin system: The underlying mechanisms and promising therapeutical target for depression and anxiety

Gong

Deng

2023

Front. Immunol.

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Emotional disorders, including depression and anxiety, contribute considerably to morbidity across the world. Depression is a serious condition and is projected to be the top contributor to the global burden of disease by 2030. The role of the renin-angiotensin system (RAS) in hypertension and emotional disorders is well established. Evidence points to an association between elevated RAS activity and depression and anxiety, partly through the induction of neuroinflammation, stress, and oxidative stress. Therefore, blocking the RAS provides a theoretical basis for future treatment of anxiety and depression. The evidence for the positive effects of RAS blockers on depression and anxiety is reviewed, aiming to provide a promising target for novel anxiolytic and antidepressant medications and/or for improving the efficacy of currently available medications used for the treatment of anxiety and depression, which independent of blood pressure management.

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Section: Potential Mechanisms Of Ras Blockers-induced Antidepressant/...mentioning

confidence: 99%

Renin-angiotensin system: The underlying mechanisms and promising therapeutical target for depression and anxiety

Gong

Deng

2023

Front. Immunol.

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“…Studies have shown that SSRIs are efficacious against atherosclerosis, CAD, and depression [ 19 ]. Antidepressant effects are seen with statins, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARB), and aspirin by various mechanisms, while calcium channel blockers (CCBs), diuretics, and nitrates are associated with depression [ 34 ]. Only 30% of patients taking SSRIs are also undergoing psychotherapy [ 24 ].…”

Section: Reviewmentioning

confidence: 99%

The Risk of Fatal Arrhythmias Associated With Sertraline in Patients With Post-myocardial Infarction Depression

Gutlapalli¹,

Prakash²,

Swarnakari³

et al. 2022

Cureus

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Sertraline is a first-line antidepressant and the most commonly used in the treatment of selective serotonin reuptake inhibitor (SSRI) in major depression. It is preferred due to its central and peripheral actions on the serotonergic system in patients with mental health issues as well as cardiovascular disease, particularly post-myocardial infarction depression. Some of the feared adverse effects include QT prolongation, arrhythmias including Torsades de pointed, and sudden cardiac death, which are associated with older antidepressants and are rarely seen with SSRIs, including sertraline. We tried to understand the risks associated with sertraline use in cardiac patients. We reviewed all the relevant information from inception up to July 2022 regarding the risks of sertraline use in cardiovascular diseases, particularly with a focus on post-myocardial infarction depression, and gathered around 500 articles in our research and narrowed it down to 37 relevant articles. The database used was PubMed and the keywords used are sertraline, arrhythmia, major depression, post-myocardial infarction, and ventricular tachycardia. We carefully screened all relevant articles and found articles supporting and refuting the effects of sertraline in increasing cardiovascular morbidity and mortality. We concluded that there is a significant variability due to confounding factors affecting individual cases. Overall, sertraline has no increased risk in comparison with other antidepressants and a comparatively preferable safety profile to other SSRIs like citalopram in general cases. Any patient with a high risk of arrhythmias due to any etiology should receive a screening ECG before sertraline prescription for baseline QT interval and genotyping for any serotonin transporter/receptor variations. Patients should also be periodically monitored for drug-drug interactions while on therapy. We encourage further research, including randomized clinical trials and post-marketing surveillance regarding the use of sertraline in high-risk cases.

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“…Besides statins, various drugs such as aspirin, metformin, angiotensin-converting enzyme inhibitors, and angiotensin II receptor inhibitors have also exhibited antidepressant effects [ 33 ], whereas calcium channel blockers (CCBs), diuretics, and nitrates are associated with an increased risk of depression [ 34 ].…”

Section: Reviewmentioning

confidence: 99%

Statins and Antidepressants: A Comprehensive Review and Clinical Outlook of the Risks and Benefits of Co-prescription (2022)

Gutlapalli¹,

Chaudhuri²,

Khan³

et al. 2022

Cureus

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Antidepressants are the most prescribed medications in the United States, and the most frequently prescribed antidepressants are selective serotonin reuptake inhibitors (SSRIs) followed by serotoninnorepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), serotonin antagonist and reuptake inhibitors (SARIs), and norepinephrine-dopamine reuptake inhibitors (NDRI). On the other hand, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, also known as statins, are the most prescribed lipid-lowering medications, and because the majority of patients with cardiovascular disease (CVD) have depressive symptoms, it is essential to understand the possible drug-drug interactions these two classes of medications can have, their potential synergistic mechanisms, and possible risks. In our research, we tried to understand the facts and uncover any missing links regarding the potential risks and benefits of statins and antidepressant co-prescription in the current clinical scenario. We reviewed all the relevant information from inception up to October 2022 regarding the antidepressant and statin polypharmacy. The databases we used were PubMed and PubMed Central, and the 11 keywords were "statins," "SSRI," "SNRI," "selective serotonin reuptake inhibitors," "serotonin-norepinephrine reuptake inhibitors," "antidepressants," "HMG-CoA reductase inhibitors," "tricyclic antidepressants," "monoamine oxidase inhibitors," "serotonin antagonist and reuptake inhibitors," and "norepinephrine-dopamine reuptake inhibitors." We carefully screened each of the relevant articles, including animal and human studies. In our study, we concluded that co-prescription of statins and SSRIs/SNRIs was generally safe and should be encouraged due to the potential synergistic nature of their effects in patients with CVD and major depression, and caution is advised with all other classes of antidepressants. We would like to encourage the undertaking of large-scale observational studies and proactive postmarketing surveillance to improve our knowledge regarding this topic considering the immense clinical importance it holds by directly and indirectly affecting half the population worldwide.

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Association between common cardiovascular drugs and depression

Cited by 15 publications

References 81 publications

Renin-angiotensin system: The underlying mechanisms and promising therapeutical target for depression and anxiety

Renin-angiotensin system: The underlying mechanisms and promising therapeutical target for depression and anxiety

The Risk of Fatal Arrhythmias Associated With Sertraline in Patients With Post-myocardial Infarction Depression

Statins and Antidepressants: A Comprehensive Review and Clinical Outlook of the Risks and Benefits of Co-prescription (2022)

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