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Antidepressant Appears Safe and Effective for Depressed, Hospitalized Heart Patients

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Duke Health News 919-660-1306

DURHAM, N.C. -- Of the 1 million Americans hospitalized annually for a heart attack, about 20 percent will also suffer from depression, which greatly increases their risk of dying. Most of these patients are not treated with antidepressants, however, since older antidepressants were known to be cardiotoxic and the effects of the new antidepressants were unknown.

In a study to be published in the Aug. 14, 2002 issue of the Journal of the American Medical Association (JAMA), the drug sertraline (Zoloft), an SSRI (selective serotonin reuptake inhibitor) antidepressant, has been found to be safe and effective in 369 depressed patients recently hospitalized for heart attack. Patients with a history of two prior episodes of depression showed a 78 percent improvement while taking sertraline while only 45 percent improved on placebo. There was almost no difference between the drug and the placebo in patients who had never experienced a bout of depression before their hospitalization. Additionally, there was a 23 percent reduction in life-threatening cardiovascular events in people taking the drug.

Dr. Christopher O'Connor, associate professor of cardiology at Duke University Medical Center, Durham, NC, and Dr. Alexander Glassman, professor of clinical psychiatry at Columbia University College of Physicians & Surgeons, New York, were co-principal investigators of the study. For interviews with Dr. O'Connor, contact the Duke University Medical Center News Office at 919-684-4148 or richard.puff@duke.edu. For interviews with Dr. Glassman, who was the paper's lead author, contact Annie Bayne at 212-305-3900 or as862@columbia.edu.

Although depressed patients are three times more likely to die after their first hospitalization for a heart attack than patients who are not depressed, doctors do not prescribe antidepressants to people with heart conditions. The older tricyclic drugs are dangerous for heart patients, and until now, no studies using SSRIs, a newer class of antidepressants, had ever been performed in a population of patients who recently experienced a heart attack.

The study, which took place at 40 medical centers throughout the world, was sponsored by Pfizer, Inc., which manufactures Zoloft, and by the National Institutes of Health and the New York State Department of Mental Hygiene.

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