Mills Paul J, Dimsdale Joel E, Hong Suzi, Van Den Brande Geoffrey, Redwine Laura, Greenberg Barry H, Rutledge Thomas
Department of Psychiatry;
Patient Prefer Adherence. 2008 Feb 2;2:333-6. doi: 10.2147/ppa.s4424.
Depression is common in heart failure (HF), but there is little data on the characteristics of antidepressant use in patients with HF.
To survey basic information on antidepressant prescription characteristics, use, effectiveness, and follow-up.
Observational study in two outpatient cardiology clinics of 37 NYHA class I-IV HF patients taking antidepressant medication.
Thirty-one percent of prescriptions for antidepressants were obtained from psychiatrists, 58% from primary care physicians, and 8% from cardiologists. The majority of patients (87%) reported regularly taking their antidepressant medication as prescribed, however 48% reported never having had the dosage of their antidepressant medication adjusted. Only 53% of the patients reported that the medication had helped their mood "almost entirely" or "mostly" back to normal since starting their antidepressants, while the remaining patients reported that their mood was only "halfway" or "somewhat" back to normal or that the medication had not helped their depression at all. Among a subset of 10 patients who completed the Beck Depression (BDI) inventory, 6 still had depressed mood (BDI >/= 10).
The findings from this survey study provide insight into the characteristics of antidepressant use in patients with HF and argue for better follow up of HF patients who are prescribed antidepressants.
抑郁症在心力衰竭（HF）患者中很常见，但关于HF患者使用抗抑郁药的特征的数据很少。
调查抗抑郁药处方特征、使用情况、有效性及随访的基本信息。
在两家门诊心脏病诊所对37例服用抗抑郁药的纽约心脏协会（NYHA）心功能I - IV级的HF患者进行观察性研究。
31%的抗抑郁药处方来自精神科医生，58%来自初级保健医生，8%来自心脏病专家。大多数患者（87%）报告按规定定期服用抗抑郁药，然而48%的患者报告从未调整过抗抑郁药的剂量。只有53%的患者报告自开始服用抗抑郁药以来，药物已“几乎完全”或“大部分”帮助其情绪恢复正常，而其余患者报告其情绪仅“部分”或“有点”恢复正常，或者药物对其抑郁症状毫无帮助。在完成贝克抑郁量表（BDI）的10例患者子集中，6例仍有抑郁情绪（BDI≥10）。
这项调查研究的结果为了解HF患者使用抗抑郁药的特征提供了依据，并主张对开具抗抑郁药处方的HF患者进行更好的随访。
