Treatment of post-myocardial infarction depressive disorder

Abstract

Both major and minor depressive disorder post-myocardial infarction (MI) are associated with an increased risk of all-cause mortality, cardiac mortality and new cardiovascular events. Post-MI depressive disorder predicts slow recovery and poor quality of life. This review attends to post-MI depressive disorder, its underlying mechanisms and options for and effects of treatment. Evidence has been found for several mechanisms to be involved in the pathophysiology, including hypothalamus-pituitary-adrenal axis activity, immune activity, polyunsaturated fatty acids, serotonin, platelet activation, type D personality and negative health behavior. Five leading randomized controlled trials are discussed, showing safety and efficacy of antidepressive treatment in post-MI patients. Effects on cardiac outcome remain unclear.

Coronary Heart Disease and Depression or Anxiety: A Bibliometric Analysis

“…Depression will also have a negative influence on the QoL in patients post-MI (de Jonge et al, 2006 ). The underlying mechanism between depressive disorder and MI may depend on enhanced immune activity, stimulated hypothalamic-pituitary-adrenal (HPA) axis, decreased polyunsaturated fatty acids, increased platelet activity and serotonin, and negative health behavior and personal characteristics like type D personality (Kuyper and Honig, 2008 ). Even if depression seems to be much less critical in a patient with MI, physicians are supposed to make an early diagnosis of depression and offer positive treatments.…”

Intrauterine Programmierung von Störungen der Hirnfunktion im späteren Leben

“…Patient hat innerhalb eines Jahres nach einem Schlaganfall [246,247] und jeder 4. Patient hat nach einem Myokardinfarkt depressive Symptome [248][249][250] . Die Prävalenz von Depressionen ist der von Patienten mit einer neu diagnostizierten koronaren Herzkrankheit ähnlich, wo ebenfalls etwa jeder 4.…”

A Depressed Post-Menopausal Woman

“…One wonders how many older women perceived by clinicians as isolated or lonely are presenting to EDs with anginal equivalents that are being underdiagnosed. Post-myocardial infarction patients should be evaluated for depression and, if necessary, treated aggressively for better overall outcomes (26)(27)(28).…”

“…It is therefore of paramount importance that clinicians recognize and treat post-myocardial infarction depression. Because selective serotonin reuptake inhibitors are safe, and depression post-myocardial infarction impacts negatively on quality of life, they should be used aggressively with other modes of therapy (22)(23)(24)(25)(26)(27)(28). The evidence is clear that mind and body need to be considered concurrently to improve patient outcome (29).…”