Antidepressants and Heart Attacks

Many people these days take antidepressants for all types of different reasons; depression and anxiety are usually the top culprits, but for whatever the reason, people take these drugs to help them get through their days in a healthy way.  After heart attacks (AKA Myocardial Infarctions "MI's"), many people suffer from depression, and the depression that can ensue increases your risk of death (either from another heart attack or other reasons).  The risk of heart attack from the use of antidepressants has not really been well studied....so putting people on antidepressants after a heart attack to prevent post-heart attack depression might not be a good idea, right?

As it so happens...
A large study from one of the Veteran's Affairs Hospitals in the US, looking at people from mid 20's-80's who were on antidepressants, for whatever reason, and patients post heart attack with and without antidepressant medications, to compare their rate of heart attacks after 12 weeks of use.  The patients on antidepressants had a HUGE reduction in risk of death 6 months after heart attacks when they took antidepressants as part of their follow-up care.

Are any drugs better?
SSRI's -serotonin selective reuptake inhibitors  (like Paxil/Prozac/Celexa/etc)
SNRI's -serotonin noreipnephrine reuptake inibitors (like Effexor/Cymbalta/etc)
TCA's- Tricyclic Antidepressants (like Elavil/Noveril/etc)
Basically, all of the antidepressants worked the same, and had the same result rates, which is a significant reduction in heart attacks or death after a heart attack.

Why do they work??
It really is unclear, at this point.  It is assumed because stress levels are reduced and people are feeling better, less depressed, and it leads for a reduced risk of further heart attacks.  As well, there is an assumption that it might be related to compliance with taking medications; people who need to take medications at a certain time, are usually more apt to take all of their medications on time and every day.

So, what it comes down to is: who knows why antidepressants help people after a heart attack to not have another one?  But they do!  They help stave off post heart attack depression, making people feel better AND actually be physically better!  If you have suffered from a heart attack or know someone who has, and if they are suffering depression, then talk to your HCP about the risks and benefits of antidepressant use.  It may be the right choice for you!

Yours in Good Health
B