首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Pharmacologic treatment of depression in patients with heart disease.
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Pharmacologic treatment of depression in patients with heart disease.

机译:心脏病患者抑郁症的药物治疗。

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The relationship between depression and cardiovascular disease is complex and multifaceted. There is a growing body of evidence that depression significantly and adversely affects cardiovascular health. Perhaps the most prominent finding is the documented increase in mortality rate in patients with depression after myocardial infarction. The critical questions of interest to both the clinician and researcher are whether there are safe and effective treatments for depression in patients with heart disease and whether treatment of depression reduces the increased risk of cardiac morbidity and mortality. Although the data are limited and are primarily from open or comparator trials, the tricyclics (TCAs) and selective serotonin reuptake inhibitors (SSRI) are effective for treatment of depression in patients with ischemic heart disease (IHD), and response rates are comparable with those reported in depressed patients without heart disease. In terms of safety, the TCAs are associated with documented adverse cardiovascular effects, including increases in heart rate, orthostatic hypotension, and conduction delays. Use of TCAs in patients with IHD carries a proven increased risk of cardiac morbidity and perhaps of mortality as well. The SSRI appear to be relatively safe and effective in the treatment for depression in patients with comorbid IHD.
机译:抑郁与心血管疾病之间的关系是复杂且多方面的。越来越多的证据表明,抑郁症严重影响心血管健康。也许最突出的发现是有记录的心肌梗死后抑郁症患者的死亡率增加。临床医生和研究人员都关心的关键问题是,对于心脏病患者是否存在安全有效的抑郁症治疗方法,以及抑郁症治疗是否可以降低心脏病和死亡的风险。尽管数据有限,并且主要来自开放或比较试验,但三环类药物(TCA)和选择性5-羟色胺再摄取抑制剂(SSRI)可有效治疗缺血性心脏病(IHD)患者的抑郁症,其缓解率与那些患者相当报道无心脏病的抑郁症患者。在安全性方面,TCA与心血管不良事件有关,包括心率增加,体位性低血压和传导延迟。在IHD患者中使用TCA已证明会增加患心脏疾病的风险,甚至可能会增加死亡率。 SSRI似乎在合并IHD合并症患者的抑郁症治疗中相对安全有效。

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