Chapter 11 - Depression and heart disease

Summary

The American Heart Association and others have recommended screening for depression among those with cardiovascular disease (CVD). It has been further suggested that this screening should occur at least quarterly. In addition to an appropriate and targeted work-up for CVD, patients should be screened for conditions related to depression and heart disease, such as sleep apnea. Once the diagnosis of depression has been made, a variety of treatment options are available. These include antidepressants, psychotherapy, and exercise. Relaxation and stress management approaches also may be of benefit. Beta-blockers do not cause depression and should not be avoided in patients with depression and CVD. Although case reports have documented a number of psychiatric adverse effects of hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors or statins, such effects have not been reported in systematic studies. Use of statins does not appear to increase risk of suicide.