Efficacy of prophylactic treatment with selective serotonin reuptake inhibitors for depression after open-heart surgery

Hata, Mitsumasa; Yagi, Yuko; Sezai, Akira; Yoshitake, Isamu; Wakui, Shinji; Takasaka, Ayako; Kawachi, Hideomi; Murakami, Tomohiko; Minami, Kazutomo; Shiono, Motomi

doi:10.1007/s00595-010-4357-2

Cited by 9 publications

(21 citation statements)

References 20 publications

(25 reference statements)

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“…A recent study suggests that antidepressant use may help protect cardiac patients against cardiac related death while in the hospital (Hata et al, 2011). However, several limitations of the study are worth noting: specifically, the sample size was small, patients were not randomized to the antidepressant treatment, and it was not placebo-controlled.…”

Section: Cardiac Eventsmentioning

confidence: 99%

Primum Non Nocere: An Evolutionary Analysis of Whether Antidepressants Do More Harm than Good

Andrews¹,

Thomson²,

Amstadter³

et al. 2012

Front. Psychology

105

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Antidepressant medications are the first-line treatment for people meeting current diagnostic criteria for major depressive disorder. Most antidepressants are designed to perturb the mechanisms that regulate the neurotransmitter serotonin – an evolutionarily ancient biochemical found in plants, animals, and fungi. Many adaptive processes evolved to be regulated by serotonin, including emotion, development, neuronal growth and death, platelet activation and the clotting process, attention, electrolyte balance, and reproduction. It is a principle of evolutionary medicine that the disruption of evolved adaptations will degrade biological functioning. Because serotonin regulates many adaptive processes, antidepressants could have many adverse health effects. For instance, while antidepressants are modestly effective in reducing depressive symptoms, they increase the brain’s susceptibility to future episodes after they have been discontinued. Contrary to a widely held belief in psychiatry, studies that purport to show that antidepressants promote neurogenesis are flawed because they all use a method that cannot, by itself, distinguish between neurogenesis and neuronal death. In fact, antidepressants cause neuronal damage and mature neurons to revert to an immature state, both of which may explain why antidepressants also cause neurons to undergo apoptosis (programmed death). Antidepressants can also cause developmental problems, they have adverse effects on sexual and romantic life, and they increase the risk of hyponatremia (low sodium in the blood plasma), bleeding, stroke, and death in the elderly. Our review supports the conclusion that antidepressants generally do more harm than good by disrupting a number of adaptive processes regulated by serotonin. However, there may be specific conditions for which their use is warranted (e.g., cancer, recovery from stroke). We conclude that altered informed consent practices and greater caution in the prescription of antidepressants are warranted.

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Section: Cardiac Eventsmentioning

confidence: 99%

Primum Non Nocere: An Evolutionary Analysis of Whether Antidepressants Do More Harm than Good

Andrews¹,

Thomson²,

Amstadter³

et al. 2012

Front. Psychology

105

View full text Add to dashboard Cite

show abstract

“…Ten studies were identified by systematic search to fulfil the inclusion criteria (Table 1) (15)(16)(17)(18)(19)(20)(21)(22)(23)(24).…”

Section: Resultsmentioning

confidence: 99%

“…All ten studies (15)(16)(17)(18)(19)(20)(21)(22)(23)(24) reported the outcomes of either 30-day hospital or all-cause mortality, or long-term survival. Two studies (15,23) reported higher mortality in the SSRI group.…”

Section: Mortalitymentioning

confidence: 99%

“…Hata et al (24) conducted a retrospective study of 117 female patients over the age of 70 undergoing cardiac surgery, of whom 58 patients were given prophylactic SSRI post-operatively and 59 patients were controls. Outcomes of interest were the duration of hospital stay; the incidences of cerebrovascular complications, pneumonia and hospital mortality between the two groups.…”

Section: Mortalitymentioning

confidence: 99%

“…Ghassemi et al(23) reported significantly higher hospital mortality [odds ratio (OR): 1.45, 95% CI: 1.07-1.95, P=0.016] in the SSRI group. Seven other studies(16)(17)(18)(19)(20)22,24) reported no significant difference in 30-day or hospital mortality, and of these studies 3 studies(18,20,22) and 1 additional study(21) reported no significant difference in all-cause mortality between SSRI and non-SSRI groups. Xiong et al(16) reported the total units of postoperative RBC transfused to be higher in the SSRI group(6.1 vs. 5.2, P=0.04).…”

mentioning

confidence: 97%

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Selective serotonin reuptake inhibitor use and outcomes following cardiac surgery—a systematic review

et al. 2018

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A high prevalence of depression is observed in patients undergoing cardiac surgery, and depression has been shown to be an independent predictor of morbidity and mortality in this patient population. Selective serotonin re-uptake inhibitors (SSRIs) are the first-line recommended therapy for depressive disorders, however due to their platelet inhibitory actions they have been associated with increased incidences of post-operative bleeding. This review has sought to address whether the use of SSRIs is associated with a higher rate of mortality, major adverse events or bleeding events following cardiac surgery. A retrospective literature search selected studies comparing the use of SSRIs with no SSRI use in patients undergoing cardiac surgery. Seven of the ten studies analysed reported no significant difference in mortality in SSRI users. Five of the seven studies reporting bleeding events demonstrated no significant difference in SSRI users. Three of the five studies reporting other significant morbidity demonstrated no significant difference in SSRI users. Our study demonstrates the safety of the use of SSRIs for the treatment of depressive disorders in patients undergoing cardiac surgery.

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Selective Serotonin Reuptake Inhibitor Use and Perioperative Bleeding and Mortality in Patients Undergoing Coronary Artery Bypass Grafting: A Cohort Study

et al. 2015

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Efficacy of prophylactic treatment with selective serotonin reuptake inhibitors for depression after open-heart surgery

Abstract: The quality of life of patients with depression after open-heart surgery is poor. The early administration of prophylactic medication is therefore necessary for those patients at risk for developing depression.

Cited by 9 publications

References 20 publications

Primum Non Nocere: An Evolutionary Analysis of Whether Antidepressants Do More Harm than Good

Primum Non Nocere: An Evolutionary Analysis of Whether Antidepressants Do More Harm than Good

Selective serotonin reuptake inhibitor use and outcomes following cardiac surgery—a systematic review

Selective Serotonin Reuptake Inhibitor Use and Perioperative Bleeding and Mortality in Patients Undergoing Coronary Artery Bypass Grafting: A Cohort Study

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