Depression: As a Risk Factor for Coronary Heart Disease

Abstract

We conducted a review to resolve whether there is relationship between depression and coronary heart disease or not. Depression is a mental health problem which is spread widely and most of physicians are well acquainted with this concept of depression. Diagnosis of depression disorder based on continuity of illness, etiology of illness and number of symptoms - all these discriminations should be reported during inspecting the link between depression and coronary heart disease. We review the mechanism of linking depression and coronary heart disease i.e. relationship between depression and inflammation, depression and autonomic dysfunction, CHD and autonomic dysfunction, depression and Sleep architecture disruption, depression and circadian rhythm disruption, CHD and circadian rhythm disruption, and depression and behavioral mechanism. There is bidirectional association between depression and coronary artery disease i.e. coronary artery disease can cause major depressive disorder and depression is risk factor for CAD and its complications. Major depression is a devastating comorbid disease that can make recovery difficult and increase risk of cardiac mortality and morbidity. We also go over the therapy options like Psychotherapy, Electroconvulsive therapy, Exercise etc. But there are some antidepressant medications also available for treating depression in patients associated with CAD. The antidepressant medications like SSRIs e.g. Sertraline, fluoxetine, citalopram etc. appears to be safe in individual with depression and concomitant CAD or unstable angina. However, some evidence suggests that SSRIs like tricyclics, may increase risk cardiac events and death when taken for long time. New classes of antidepressants have dual reuptake inhibition for serotonin and nor-epinephrine e.g. venlafaxine. These medications are slightly more successful than SSRIs in treating depression, but they also have some adverse effects. Selegiline transdermal form was recently licensed for the treatment of MDD. Oral selegiline is not effective antidepressant. When compared to oral selegiline, STS results in stable plasma levels of drug and increased drug concentration in the brain.