REVIEW

Heart and mind: (2) psychotropic and cardiovascular therapeutics

S U Shah¹, Z Iqbal², A White³ and S White³

¹ University Hospital Birmingham and University of Birmingham, Birmingham, UK
² Department of Cardiology, Ysbyty Gwynedd, Bangor, North Wales, UK
³ University Hospital Birmingham, Birmingham, UK

Correspondence to:
Correspondence to:
Dr Saeed Ullah Shah
Department of Cardiology, Ysbyty Gwynedd, Bangor, North Wales, UK; saeedshah{at}miranshah.freeserve.co.uk

There is a plausible biological basis for the association between psychiatric morbidity and cardiovascular disease. Anxiety, panic disorder, and depression are common in patients with coronary heart disease and hypertension. Despite this evidence there is poor recognition of anxiety disorders and depression in primary care and hospital medical practice. Concern also surrounds the use of psychotropic drugs in patients with cardiovascular disease. In the first of the two articles on this subject, we highlighted the current evidence regarding the association between cardiovascular and psychotropic conditions. In this second article, we discuss the interaction of the drugs used in the management of these two varied but commonly coexistent group of diseases as well as their relative effects on either system. Finally, we summarise the data regarding the safe use of these medications based on the recommendations from the currently available evidence.

Abbreviations: CSM, Committee on Safety of Medicines; GABA, gamma amino butyric acid; SSRI, selective serotonin reuptake inhibitor

Keywords: antidepressants; anxiety; depression; cardiovascular disease; psychiatric disease; drug interaction; pharmacotherapy

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