Cardiovascular effects of antidepressant drugs

It has long been evident that the tricyclic antidepressants have serious cardiovascular effects. This becomes an increasingly important issue as patient populations age. In addition, there is now strong evidence that depression increases the incidence of ischemic heart disease. Taken together these issues make the safety of antidepressant drugs even more important. The tricyclic antidepressants have long been able to produce orthostatic hypotension and this propensity is increased in patients with cardiac disease. In addition, the tricyclics prolong conduction and in overdose this leads to serious cardiac complications. Although only a limited amount of data are available, the serotonin reuptake inhibitors show no evidence of harm. In fact, there is some evidence that the selective serotonin reuptake inhibitor drugs may be beneficial for patients with cardiovascular disease.