The use of antidepressant drugs in patients with heart disease.

Both depression and cardiovascular disease are common as people age and are, therefore, likely to coexist. It has become evident recently that the rate of this comorbidity exceeds substantially what is expected by chance. A major problem arises in that there is increasing evidence that the tricyclic antidepressants (TCAs) carry more risk than originally thought in patients with ischemic heart disease. This risk increases the importance of understanding both the safety and efficacy of the serotonin selective reuptake inhibitors (SSRIs) in this population. Three recent studies on safety data in patients with overt heart disease are now available: although the total of 94 patients limits the ability to make generalizations, the data that are available give little evidence of harm and even suggest that SSRIs may have beneficial effects in ischemic heart disease.