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Robert M. Carney, PhD; Allan S. Jaffe, MD

JAMA. 2002;288:750-751.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Depression is a risk factor for mortality after acute myocardial infarction (MI), and it predicts a slow recovery and a poor quality of life.^1-4 Nevertheless, only a minority of patients who are depressed after an MI receive treatment for their depression. In the past, the only available antidepressants had cardiotoxic effects and were contraindicated for many patients with heart disease, particularly older patients at risk for orthostatic hypotension and patients with left bundle branch block.⁵ Some of the older antidepressants also have proarrhythmic effects.⁶

The newer selective serotonin reuptake inhibitor (SSRI) antidepressants are free of cardiotoxic effects in relatively healthy depressed patients.⁷ However, because heart disease has remained a standard exclusion criterion in clinical trials of antidepressants, very little is actually known about the safety and efficacy of antidepressants for depressed patients with heart disease. Psychotherapy is a safe and effective alternative . . . [Full Text of this Article]

Author Affiliations: Department of Psychiatry, Washington University School of Medicine, St Louis, Mo (Dr Carney); and Departments of Medicine/Cardiology and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minn (Dr Jaffe).

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