March 25, 2015
Antidepressants Outperform Statins in Reducing Depressed Patients’ CV Risk

San Diego—Antidepressants may be even more beneficial than statins in reducing the risk of heart disease in patients with moderate-to-severe depression, according to a new study.

That’s according to researchers at the Intermountain Medical Center Heart Institute in Salt Lake City who presented their findings at the American College of Cardiology's 64th Annual Scientific Session in San Diego.

For the study, touted as the first to assess the relative effects of the simultaneous use of antidepressants and cholesterol-lowering drugs in depressed patients, researchers analyzed the health records and rates of death, coronary artery disease, and stroke of more than 26,000 patients treated by Intermountain over a 3-year period.

Participants completed a nine-question depression screening questionnaire, assessing such factors as mood, sleep, and appetite, to determine their level of depressive symptoms. Based on the questionnaires, researchers identified 5,311 patients as having moderate-to-severe depression and 21,517 patients as having no-to-mild depression.

The study found that patients with moderate-to-severe depression who took antidepressants alone had a lower risk of death, coronary artery disease, and stroke than patients with moderate-to-severe depression who took neither antidepressants nor statins.

It also revealed that taking statins alone or in combination with antidepressants was not associated with a significant risk reduction in this group of patients.

Although the study does not evaluate how antidepressants decreased the risk of cardiovascular disease, the authors suggest the link could have some relation to behavioral changes.

“Antidepressants might have relevant physiological benefits, but I also think the behavioral changes that improve a person's mood can also improve cardiovascular health,” said lead author Heidi May, PhD, MSPH, a cardiovascular epidemiologist at the Intermountain Medical Center Heart Institute, May said. “This study demonstrates the importance of evaluating patients for depression, not only in terms of improving their mood, but reducing their risk for heart disease.”

“Antidepressants were not associated with a reduced cardiovascular risk in people with little or no depression, but in moderately to severely depressed people, antidepressants were shown to significantly improve cardiovascular outcomes,” May explained.

The study did not evaluate the mechanism by which antidepressants decreased the risk of cardiovascular disease.

According to the results, patients with moderate-to-severe depression who were taking antidepressants alone had a 53% lower risk of dying, developing coronary artery disease, or having a stroke during the 3-year follow-up period as compared to patients with moderate-to-severe depression who were not taking antidepressants or statins.

Study authors note that moderately to severely depressed patients taking antidepressants alone also appeared to do better than those taking statins alone or a combination of statins and antidepressants but cautioned that those relationships were not directly analyzed.

“We thought we'd see an additive effect—that taking both medications would lower the risk more than either drug alone—but we found that in the more depressed people, the antidepressant really was what made the biggest difference,” May said. “Focus is usually placed more on traditional cardiovascular risk factors and unfortunately, depression is often overlooked. This study adds to the evidence that, when used properly, antidepressants can improve cardiovascular outcomes among those with depressive symptoms.”
U.S. Pharmacist Social Connect