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Schizophrenia Case Studies

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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

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