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Monitor Antidepressant Use if at Heart Risk

A new paper suggests use of antidepressants and anti-anxiety medications may cause an increased risk of cardiovascular events among women suspected to have coronary artery disease.

Researchers at the Uniformed Services University of the Health Sciences (USU) used data garnered from an ongoing study at multiple sites around the U.S. The epidemiological study, the Women’s Ischemia Syndrome Evaluation (WISE), was designed to develop methods for improved assessment and understanding of coronary artery disease in women.

In a paper, “Psychotropic medication use and risk of adverse cardiovascular events in women with suspected coronary artery disease,” lead author David S. Krantz, Ph.D., says there are several important implications of this research for women with suspected CAD.

However, he also emphasizes that the study’s results are not definitive because the study was observation, rather than a clinical trial. An observational study measures associations or relationships (correlations) but cannot state a definitive cause and effect.

“Since depression is an important risk factor for CAD morbidity and mortality, women with suspected CAD may be inadequately treated for depression,” said Dr. Krantz.

“Taking these medications may be a marker of residual depression and residual depression in these women may account for increased CAD events. However, it needs to be considered that taking antidepressant and anti-anxiety medications may not be beneficial, and may in fact be harmful for some women.”

Dr. Krantz also said women with suspected CAD often have unexplained chest pain, since traditional diagnostic methods for CAD — for example, coronary angiography — may not reveal the presence of disease.

“Many women become distressed by the undiagnosed chest pain and are prescribed these medications for this distress,” said Dr. Krantz. Prior findings from the WISE study indicate women with persistent unexplained chest pain have diminished quality of life.

Because the WISE study is not a clinical trial, researchers need to be very cautious about concluding that antidepressant and anti-anxiety medications themselves are responsible for the results of the WISE study, since many factors could be associated with patients using these medications.

For this reason, Krantz said, further research needs to examine whether factors such as underlying depression and anxiety, and not medications per se, may be responsible for these results. These findings also emphasize the importance of emotional and psychosocial factors in women with suspected coronary artery disease.

Source: Uniformed Services University of the Health Sciences (USU)

Monitor Antidepressant Use if at Heart Risk

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Monitor Antidepressant Use if at Heart Risk. Psych Central. Retrieved on February 17, 2019, from
Scientifically Reviewed
Last updated: 8 Aug 2018
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
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