A study of cardiovascular disease, depression and antidepressants on a computerised general practice database.

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Bibliographic Details
Title:	A study of cardiovascular disease, depression and antidepressants on a computerised general practice database.
Authors:	Tyrer, F., Lawrenson, R. A., Farmer, R. D. T.
Source:	Human Psychopharmacology: Clinical & Experimental. Jun99, Vol. 14 Issue 4, p233-237. 5p. 2 Charts, 2 Graphs.
Subjects:	Cardiovascular diseases, Patients, Antidepressants, Mental depression, Diagnosis
Abstract:	Previous evidence suggests there is an association between cardiovascular disease and depression. Tricyclic antidepressants (TCAs) are contraindicated in patients with a recent history of cardiovascular disease. 5678 patients between the ages of 50 and 79 years and with a new acute cardiac event were selected from a computerised general practice database and followed up for one year. ‘New episodes’ of diagnosed depression were identified and treatment with antidepressants was investigated. 183 656 patients aged 50–79 years without a cardiac event were used for comparison. A significant association was found between cardiovascular disease and a new diagnosis of depression (adjusted OR=2.23, 95 per cent CI 1.90–2.62). Patients who had suffered a recent cardiac event were less likely to be prescribed a TCA than an SSRI (adjusted OR=0.59, 95 per cent CI 0.41–0.85). However, 35 per cent of patients with a recent cardiac event were initially prescribed a TCA. The findings indicate that general practitioners recognise the dangers of prescribing TCAs to patients with a recent history of cardiovascular disease. However, a substantial minority of cardiac patients were prescribed TCAs where they may not have been the optimal choice. Copyright © 1999 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]
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Database:	Psychology and Behavioral Sciences Collection

Description
Abstract:	Previous evidence suggests there is an association between cardiovascular disease and depression. Tricyclic antidepressants (TCAs) are contraindicated in patients with a recent history of cardiovascular disease. 5678 patients between the ages of 50 and 79 years and with a new acute cardiac event were selected from a computerised general practice database and followed up for one year. ‘New episodes’ of diagnosed depression were identified and treatment with antidepressants was investigated. 183 656 patients aged 50–79 years without a cardiac event were used for comparison. A significant association was found between cardiovascular disease and a new diagnosis of depression (adjusted OR=2.23, 95 per cent CI 1.90–2.62). Patients who had suffered a recent cardiac event were less likely to be prescribed a TCA than an SSRI (adjusted OR=0.59, 95 per cent CI 0.41–0.85). However, 35 per cent of patients with a recent cardiac event were initially prescribed a TCA. The findings indicate that general practitioners recognise the dangers of prescribing TCAs to patients with a recent history of cardiovascular disease. However, a substantial minority of cardiac patients were prescribed TCAs where they may not have been the optimal choice. Copyright © 1999 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]
ISSN:	08856222
DOI:	10.1002/(SICI)1099-1077(199906)14:4<233::AID-HUP93>3.0.CO;2-#