Intended for healthcare professionals

Rapid response to:

General Practice

Depression as a risk factor for ischaemic heart disease in men: population based case-control study

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7146.1714 (Published 06 June 1998) Cite this as: BMJ 1998;316:1714

Rapid Response:

Was the risk of ischemic heart analyzed for anti-depressant drugs?

It is a well known fact that tricyclic anti depressants(TCA)
may induce increased catecholamine activity which may be serious in an
accidental overdose.

Also A - V nodal bradycardia has been noted in depressed patients, so
that TCAs may depress the alpha adrenergic receptors and induce
orthostatic hypotension with reflex tacycardia

The point being that adverse effects of TCAs may be the real problem
in provoking ischemic heart disease symptoms rather than depresion in or
of itself.

Munir E Nassar, M.D.

Competing interests: No competing interests

11 December 1999
Munir E Nassar
Consultant cardiologist-retired
Rochester, NY, USA