Psychiatria pre prax 6/2009

The antidepressants treatment in patients with high cardiovascular risk: benefit or risk?

Antidepressive treatment with sertraline, citalopram and paroxetine in patients with high cardiovascular risks is effective and safe (group safety provided by results of clinical studies). The efficacy and safety of antidepressive drug in patients with severe depression may be enhanced by means of primary and secondary prevention, ie. by beta-blockers or statins. Our recommendation is: to monitor individual safety in patients with high cardiovascular risk before the start of antidepressant therapy and during its application by way of monitoring heart rate variability (HRV) or at least by monitoring rest heart frequency. The treatment of serious depression/anxiety in patients with cardiovascular disease should be guided in cooperation of psychiatrist and cardiologist.

Keywords: cardiovascular diseases, depression, anxiety, antidepressive drugs, efficacy, safety