Serotonin reuptake inhibitor antidepressants (SSRIs) against atherosclerosis

Abstract

SummarySelective serotonin reuptake inhibitors (SSRIs) are a class of drug widely used for treatment of mood disorders, including depression and cardiovascular disease. A search for related articles in the PubMed database was attempted. It covered studies, reports, reviews and editorials of the last 5 years.Pro-inflammatory cytokines, such as TNF-α, IL-1 and IL-6, stimulate central serotonin (5-HT) neurotransmission and are over-expressed in depression, which has been linked with hypothalamic-pituitary-adrenal axis (HPA) hyperactivity. They have also been implicated in the pathogenesis and progression of other stress-induced disorders, like myocardial infarction (MI) and coronary heart disease (CHD), as they seem to modulate cardiovascular function by a variety of mechanisms. Biological mechanisms like these may explain the link between depression and CHD. There are a variety of environmental factors as well as genetic factors that might influence the pharmacogenetics of antidepressant drugs. New generation selective serotonin reuptake inhibitor antidepressants (SSRIs) causing a reduced cardiovascular morbidity and mortality may be related to serotonin platelet abnormalities in depressed patients that are effectively treated by SSRIs. SSRIs such as fluoxetine, paroxetine, sertraline and citalopram are not only considered to be free from the cardiotoxicity of their predecessors but also to function as safe and efficacious agents against depression, platelet activation, atherosclerosis and development and prognosis of coronary heart disease. However, there is a need for more studies in order to establish the exact biochemical mechanisms that are responsible for these diseases and the immunoregulatory effects of chronic use of SSRI medications.

Desvenlafaxine reduces apoptosis in amygdala after myocardial infarction

“…Since our previous studies with SSRIs such as escitalopram and sertraline (Bah et al, 2011;Wann et al, 2009) have shown no effect on infarct size, we hypothesized that its beneficial action is mainly related to inhibition of norepinephrine re-uptake rather than serotonin. Indeed, even though SSRIs can decrease platelet activation and the development of coronary heart disease (Wozniak et al, 2011) and reduce MI risk in the long-term (Kimmel et al, 2011), no data prove that SSRIs can reduce MI size, even our own (Bah et al, 2011;Wann et al, 2009). Richardt et al (2006), however, have reported that desipramine, a tricyclic antidepressant with norepinephrine uptake inhibition properties, has a dose-related cardioprotective effect on MI size.…”

The impact of treatment with selective serotonin reuptake inhibitors on primate cardiovascular disease, behavior, and neuroanatomy

“…Some have gone so far as to recommend SSRIs to inhibit atherosclerosis progression (Wozniak et al, 2011). These recommendations stem from evidence of increased cardiovascular risk factors in depression such as arrhythmias, platelet reactivity, proinflammatory processes, cortisol concentrations, and low high-density lipoprotein cholesterol (HDLC) concentrations in women (Carney et al, 2002; Shively et al, 2009; Fantidis, 2010; Tedders et al, 2011).…”

Model Placental Barrier Phenotypic Response to Fluoxetine and Sertraline: A Comparative Study

“…CAMs were previously shown to be altered in placental disease (i.e., pre‐eclampsia and villitis) and have a time‐dependent effect in atherosclerosis, with each CAM molecule being unique . Further, studies have suggested a protective role of SSRIs in atherosclerosis, primarily thought to occur from SSRIs inducing production of pro‐inflammatory cytokines . Based on these results, the authors suggest that CAM modulation may play a partial role in SSRI‐induced protection against atherosclerosis, though further experimentation in vivo would be needed to test this hypothesis.…”

“…Studies evaluating using these drugs during pregnancy did not occur until nearly a decade after the drugs were approved, with studies focusing on neonatal outcomes . Since then, studies have shown SSRIs induce the intended neurological effects, but also side effects on other tissues, including neurodevelopmental effects, cardiovascular‐related effects, effects on endothelial cells (ECs), and effects on the placenta itself and downstream fetal tissue . As it is widely accepted that SSRIs readily pass through the placenta and can impact fetal development, studies related to the role of the placenta and drug‐induced effects on the BPB have become increasing important .…”