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Relationship between depressive symptoms and cardiac events

August 28, 2017

Both Drs. Whang and Narayan stress that although the relationship between antidepressant medicines and SCD merits further investigation to determine whether antidepressant medications directly increase the risk for heart rhythm disorders, at present the benefits of appropriately prescribed antidepressants outweigh the risk of sudden cardiac death. There was no relationship between antidepressant use and fatal CHD or nonfatal heart attack.

"We can't say antidepressant medications were the cause of higher risk of sudden cardiac death. It may well be that use of antidepressants is a marker for worse depression," adds Dr. Whang. "Our data raise more questions about the mechanisms by which depression is associated with arrhythmia and cardiac death."

Plausible explanations for the link between depression and SCD may include autonomic dysfunction, higher resting heart rates and reduced heart rate variability, according to Dr. Whang. Researchers also found an association with nonfatal MI, but this became borderline non-significant when adjusted for multiple other CHD risk factors.

Still, these study findings reinforce the need for patients with depression to be monitored closely for risk factors for coronary heart disease, since management of these risk factors can reduce the risk for mortality from coronary heart disease and sudden cardiac death.

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