Depression is common in patients who have heart disease. It has been found that 25% of patients who have heart disease have depressive symptoms (Lesperance, 2002). Depression is associated with a three fold to four-fold increase in the risk of dying in patients who have heart disease and depression versus patients who have heart disease and no depression (Lesperance, 2002). The prevalence of major depressive disorder has been a growing concern and it has led the American Heart Association to issue a recommendation that patients with CHD should be screened for depressive symptoms. However, this issue has been controversial due to lack of evidence that directly ties CHD with major depressive disorder (Blumenthal et al., 2011). In addition, the …show more content…
However, depression and mood disorders have remained largely absent from cardiac risk assessment. This could be due to the fact that depressive symptoms are harder to manage in the medical field (Fiedorowicz, 2014). In addition, the treatment of depression with non drug therapies has been shown not to reduce the risk of morbidity and mortality (Jiang et al, 2011). It is unclear whether with medical treatment through SSRIs reduces the likelihood of a cardiac event, which is a hospitalization for chest pain, heart attack, or death. The purpose of this paper is to review the evidence of whether SSRIs reduce cardiac events with patients who have depressive symptoms and heart …show more content…
While tricyclic antidepressants have been shown to lead to adverse side effects, selective serotonin reuptake inhibitors through these studies have not shown to cause “hypotension or heart rate variability” (Ruden et al., 2008). One of the major studies to first investigate the relationship of SSRIs on depressive symptoms was the SADHART trial. In the SADHART trial conducted by Glassman et al., it was found that sertraline, an SSRI, was a safe and effective treatment for patients suffering from depression and heart complications such as myocardial infarction or unstable angina and that there was a trend for reduced cardiac events for patients who took sertraline (Glassman et al., 2002). The SADHART trial was a double blind, randomized placebo controlled trial conducted in 40 outpatient cardiology clinics in the United States, Europe, Canada, and Australia. The strengths of the study were that it was a double blind placebo that randomized from across different continents. By doing this, the results of the study are more generalizable because they apply to a larger population around the world. The double blind placebo component of the study reduces bias because neither the nurse practitioner nor the patient has knowledge of whether they are taking placebo or sertraline. As a result, this reduces the probability that a nurse practitioner would behave differently
Although this case report illustrates that Dextromethorphan has rapid antidepressant effects in humans, there are very few clinical trial on the effect of Dextromethorphan on major depressive disorder. This clinical trial will be one of very few controlled evaluating the safety and efficacy of Dextromethorphan in patients with major depressive disorder. Therefore, various assumptions will be required to estimate sample size. This trial will focus on patient who have
In my Journal Article they are seeing if depression is linked to Chronic Heart Failure and whether or not the Beck Depression Inventory Test Is a reliable test to administer. Results have been said that the Beck Depression Inventory Test is a reliable instrument to assess depression in not only an individual but also in a patient with Chronic Heart Failure. Depression is something that can be a great risk factor when dealing with patients that have Chronic Heart Failure. Types of symptoms that have been said to be assimilated with depression and Chronic Heart Failure are: insomnia, anorexia, sexual impairment, and fatigue. It has been said that ranges can be between thirty one and-fifty one percent in these types of patients. A person with
Furthermore, as 5HTR2C codes for a GPCR (G-protein-coupled receptor)18 that binds to serotonin, a neurotransmitter that results in happiness and well-being, it is also likely that those with depression and anxiety may have higher rates of heart attack. Many epidemiological studies have established the comorbidity between depression and heart attacks19; there is a two-fold risk in individuals with depression of developing a cardiovascular disease. Therefore, it is recommended to also test individuals diagnosed with mental health issues to be tested for SNP 6318 to reduce risk for heart attacks.
Treatment and management of major depressive disorders can result in both cognitive behavioral therapy in conjunction with medications (Gliatto & Rai,1999). The medication of choice is usually SSRIs, however; in K.P.’s situation, the outpatient provider has previous prescribed him with Sertraline and Fluoxetine, which would make his head explode. He is currently taking Levomilnacipran (Fetzima) 40mg dose daily at home. Since Fetizma is not part of the hospital formulary, the inpatient psychiatry started K.P. on an SNRI, Bupropion (Wellbutrin XL) 150mg daily, and Divalproex Sodium (Depakote) 250mg for depression and mood stabilization. It is important to monitor and adjust the medication accordingly for response. Also, it is important to
By providing an example of patients who have several mental disorders such as depression, bipolar, and neurotic problems, “were twice as likely to have a stroke or experience heart disease that the general population” (Gregorie). She also added, “cardiologist showed how stress can trigger neurological and psychological changes that create the conditions for heart attacks” (Gregorie). With providing this information, Gregorie painted the basic overview of how depression and heart disease can cause one
When antidepressant medication is advertised, benefits and negative side effects are provided, but what is not informed to the consumer is how it actually works. The truth behind antidepressant pills is that they don’t kick in right away and may take four to six weeks before they reach their full therapeutic effect. Many also find that it takes several trials before finding the one that works (Smith). This process can be long, strenuous, and costly. Additionally, a large portion of those who try pills in the end find that they are treatment-resistant to the medication, meaning all their efforts were a waste. There exists another form of resistance as well considered “depressive breakthrough” which is defined as the return of depressive symptoms
Most common groups of drugs are known as selective serotonin reuptake inhibitors (SSRI) which increases the level of serotonin (NHS, 2014). Bernstein et al (1994) conducted a study and found out that antidepressant drugs are an effective way to treat depression in the short run, significantly helping 60-80% of people. Cuijpers et al (2011) also supported Bernstein et al (1994) study found out that medication was more effective in psychotherapy in improving symptoms (Cuijpers, et al., 2011). However (Blumenthal, et al., 1999) found that exercising was just as effective as SSRIs in treating depression in an elderly group of patients. In another study conducted by Leuchter and Witte (2002) found that depressive patients receiving drug treatments improved just as well as patients receiving a placebo. The findings suggest that effective placebo treatment induces changes in the brain function that are different from those associated with antidepressants medication, however both treatments are effective, indicating that there are other ways to improve from depression other than antidepressants, which may have side effects (Leuchter, et al., 2002). Generally antidepressants drugs are an effective way to treat depression, but only in the short term. Medication will not cure depression or possible side effects, caused by taking drugs, such as sexual problems, insomnia, and dry mouth (MayoClinic,
Many people with mild to moderate depression can be successfully treated with psychotherapy and other non medical interventions such as bright light; exercise; relaxation techniques; eliminating the use of substances like recreational drugs, alcohol and caffeine; getting regular sleep; eating a balanced diet; and stress reduction. But when these interventions have been tried and failed, or when a patient's depression is severe enough to interfere with their ability to function in their work, relationships, and self-care, doctors will recommend antidepressant medications as well. There are several different classes of antidepressants to choose from, including older medications called monoamine oxidase inhibitors (MAOIs) and tricyclics; selective serotonin reuptake inhibitors (SSRIs); norepinephrine and serotonin reuptake inhibitors; and others. Despite the differences in these medications' effects on neurotransmitters, chemical properties, side effects, and pharmaceutical company advertising, they all are EQUALLY EFFECTIVE in treating depression. The choice between them, therefore, is made on the basis of other factors. When deciding which antidepressants may be best for a given patient, a doctor should take into consideration several factors. The first is the patient's history. If a patient has
There is a close correlation between depression and stress that increase of the chance of getting heart disease. From stress there is a lot of pressure on the heart from the tightening of the blood vessels and an increase in heart rate from the stress hormones; eventually leading to heart disease. Issues within the cardiovascular system are "linked more closely to depression than to smoking, diabetes, high blood pressure, or high cholesterol" (Healthline, 2014, para. 11). The immune system is also weakened, raising the chances of infections and diseases because it is too weak to fight them off since it is undergoing constant stress. As a matter of fact, the stress hormones become suppressed; therefore struggle with fighting off bacterial infections, and
Mitrea (2007) defines antidepressants as an agent or a drug that is most commonly used to prevent or treat depression. However, in today’s society it could be said that antidepressants are being over prescribed and are being used to treat a vast range of other conditions, as well as clinical depression. When the first antidepressant was developed, manufacturers were reluctant to put it on the market due to the extremely low number of people suffering from depression. Now, antidepressant drugs have a very dominant place in the drug market, with studies showing that they are now one of the most widely prescribed categories of drugs (Mark 2010). There could be a number of reasons for this increase in
The thing that is attracting more human for using antidepressants are advertising and they pay attention to them because those who advertise it try to take people’s mind with magic words and what people do, they spent a lot of money only to become worse and not better. These ads tend to emphasize that antidepressant are needed for healing depression and they only tell for what seems good, but on the other hand they don’t tell the negative effect that may occur in a man. Therefore, advertising are just money hungry people who are trying to make a buck than to care about the right people getting the suitable thing. As Dr, James S. Gordon, a world-renowned expert in using mind-body medicine to heal depression, said:
The first antidepressant, a MAOI called Iproniazid, was used in the 1950’s, where it was accidentally discovered whilst treating patients with tuberculosis. It was found that a side effect was that the patients experienced heightened mood and euphoria. It was these side effects that led clinicians to trial the drug on patients suffering with depression, where it was found that 70% showed an improvement. The first antidepressants paved the way for the development of newer drugs which targeted specific receptors, namely SSRIs and SNRIs (Ramachandraih. C,
The occurrence of depression has been found to be independently associated with poor outcome, including poor quality of life, increased heart disease, and probably increased mortality. There is some evidence that those who have the severe heart disease are at greatest risk of an adverse outcome attributable to depression. Depression is an important independent contributor to medical and psychosocial morbidity up to 6 months after CABG.4
Approximately 20.9 million adults in the United States are currently coping with depression or a mood or anxiety disorder, and this number is seemingly on the rise (Mental Disorders In America). It is becoming more and more likely for people in the United States to be diagnosed with depression or anxiety. However, this number only accounts for the number of individuals who choose to seek professional help or medical treatment, because many people are not even aware that they could be depressed. Most of the patients that are being treated are using a variety of different techniques and medicines to enhance their mood. Some of the most popular antidepressant medications that doctors are currently prescribing are
Is depression a subject that people typically tend to brush aside? Rather than facing away from a serious issue that people suffer from in their daily lives, we should discuss the methods to help people with their struggle from depression. A common method to treat depression is the use of antidepressants. But are they effective? Do they cause more harm and danger than aid? Are there other methods that can provide greater improvement rather than a pill? Instead of using antidepressants there are other alternatives such as placebos and types of therapy that can be just as, or more effective than the use of prescription antidepressants.