Tuesday, July 15, 2003

Safety of Antidepressant Drugs in the Patient With Cardiac Disease: A Review of the Literature
Pharmacotherapy article at Medscape - "Patients with cardiac disease, specifically ischemic heart disease and heart failure, have a higher frequency of major depressive disorder than patients without cardiac disease. The pathophysiologic reason for this is not completely understood. Previous depression, other debilitating illnesses, and type A personality are risk factors for the development of depression in cardiac patients. Depression has been shown to lower the threshold for ventricular arrhythmias. Therefore, treatment of depression potentially may prolong life in these patients. Antidepressant options that have been evaluated include several of the tricyclic antidepressants, trazodone, bupropion, and several of the selective serotonin reuptake inhibitors. Individual antidepressant drugs vary in their pharmacologic activity and side-effect profiles. Although clinical data are limited, it is important to individualize therapy in order to minimize cardiac adverse effects. Clinicians are encouraged to evaluate patients with cardiac disease for major depressive disorder and to consider antidepressant drug therapy for these patients when appropriate." [Viewing Medscape resources requires registration, which is free].  
  

Structured Care Key in Treating Depression in Minority Women
Milwaukee Journal Sentinel story reprinted at PsycPORT - "Providing transportation and child care and taking extra time to establish trust are key components in improving the treatment of depression in low-income minority women, a new study says. The study is one of the first involving primarily blacks and Hispanics -- who traditionally have been underrepresented in such studies -- and suggests that these extra steps, coupled with anti- depressant medication or psychotherapy, are the most effective way to improve their depression symptoms. The study is published in the Journal of the American Medical Association."