Understanding the Effect of Anti-Depressant Treatment on Cardiac Function in Women
C. Neill Epperson, MD, Associate Professor of Psychiatry (Collaborator: Christopher J. Howes, MD)
Cardiovascular disease (CVD) and depression are among the most important health concerns for women. CVD is the leading cause of mortality among women, and women are twice as likely as men to experience depression. Furthermore, nearly half of women suffer from depressive symptoms after a heart attack. Pharmacological agents known as Selective Serotonin Reuptake Inhibitors (SSRIs), the most frequently prescribed antidepressants in the United States, can be effective in treating depression and are commonly used in post heart attack depression. However, there have been concerns that SSRIs can have negative effects on protective vascular mechanisms, making them potentially of concern, particularly in those who have diagnosed CVD. Dr. Epperson’s study was designed to compare the effect of three SSRIs (sertraline, citalopram and fluoxetine) on a marker of endothelial function, the workings of the inner linings of blood vessels, which is an early indicator of the development of cardiovascular disease in women with depression.
Highlighted Study Findings
In this Ethel F. Donaghue Women’s Health Investigator Program-funded study, Dr. Epperson conducted a prospective blinded study in 29 women with depressive symptoms. Although all three of the SSRIs were effective in relieving depressive and anxious symptoms, treatment with sertraline was associated with a modest improvement in endothelial function, as compared with a modest decrease in function with the use of the other two SSRIs. This observation may make sertraline a more attractive antidepressant agent in women at risk for vascular dysfunction, such as that found in coronary artery disease.