Effective treatments for depression and coronary artery disease

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Many people who have coronary artery disease (CAD) also develop . Depression can make heart problems worse too. Psychological treatment and certain medications can relieve that develops after distressing events like a or surgery.

Coronary artery disease (CAD) is caused by a narrowing of the blood vessels that supply the muscles of the heart (coronary arteries). This means that the heart doesn't get enough oxygen because the blood vessels allow less blood to flow through. Coronary artery disease can lead to chest pain, a heart attack, heart failure and an irregular heartbeat. Many people who have coronary artery disease also develop .

Heart disease can cause depression

Depression that is linked to coronary artery disease is particularly common after a . Research has shown that about one in five people who have to stay in hospital for treatment will develop requiring treatment afterwards. Many more will have milder symptoms of following a . The majority of people who develop symptoms of after a are likely to remain depressed for one to four months after leaving the hospital. Sometimes still affects the person's emotional and physical wellbeing five years after the .

Depression increases the risk of heart problems

So heart attacks and similar health problems increase the chances of developing . On the other hand, long-lasting increases the likelihood of heart disease: It slows recovery and can increase the overall risk of illness and death. There are various biological mechanisms that might make affect the heart. But specific behavioral habits that are more common in people with might also play a role, such as smoking or not getting enough exercise.

Research on psychological treatments and medications

The psychological treatment options for include cognitive behavioral therapy and psychoanalysis, as well as support and information services. Medications known as antidepressants are also available.

Various studies have looked into how to relieve the symptoms of in people who have coronary artery disease. These studies tested the benefits of psychological treatments and medications. All of the participants in the studies had serious heart problems: Most of them had recently had a or surgery. Some people who had episodes of chest pain (angina) were also included.

The benefits of psychological treatments

The studies showed that psychological support and treatment can relieve in people who have had a or surgery. These interventions also improved quality of life. The studies focused mostly on a brief form of cognitive behavioral therapy. Cognitive behavioral therapy helps you learn how to change your behaviors and attitudes, work on current problems, and find concrete solutions. It's not clear whether psychological treatment can lower the risk of developing heart disease again over the long term.

Benefits of medication

Antidepressants were also found to reduce in people with coronary artery disease. They are often combined with psychological treatments. But the medications are only suitable for moderate to severe . Most of the studies tested one group of antidepressants known as selective serotonin re-uptake inhibitors (SSRIs). While SSRIs are suitable for people with heart problems, other antidepressants like tricyclic antidepressants and monoamine oxidase inhibitors (MAO inhibitors) are not.

Baumeister H, Hutter N, Bengel J. Psychological and pharmacological interventions for depression in patients with coronary artery disease. Cochrane Database Syst Rev 2011; (9): CD008012.

Nieuwsma JA, Williams JW, Namdari N, Washam JB, Raitz G, Blumenthal JA et al. Diagnostic Accuracy of Screening Tests and Treatment for Post-Acute Coronary Syndrome Depression: A Systematic Review. Ann Intern Med 2017; 167(10): 725-735.

Ostuzzi G, Turrini G, Gastaldon C, Papola D, Rayner L, Caruso R et al. Efficacy and acceptability of antidepressants in patients with ischemic heart disease: systematic review and meta-analysis. Int Clin Psychopharmacol 2019; 34(2): 65-75.

Reid J, Ski CF, Thompson DR. Psychological interventions for patients with coronary heart disease and their partners: a systematic review. PLoS One 2013; 8(9): e73459.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on June 18, 2020

Next planned update: 2023


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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