Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Antidepressant therapy in patients with cardiovascular diseases

Full Text:


Depression is the most common form of mental illness in patients with cardiovascular diseases (CVD). Depression and CVD can worsen the clinical and dynamic characteristics of each other. The timely detection and adequate psychopharmacotherapy of depressive states in patients with CVD are of great clinical, therapeutic, and prognostic importance. Anti-antidepressant therapy promotes a more pronounced somatic stabilizing effect in patients with CVD. Adverse events to the use of antidepressants in patients with CVD may be associated with their negative effect on the hepatic cytochrome CYP450 isoenzymes involved in the metabolism of various drugs. The authors' own data of clinical psychopharmacotherapeutic studies and the results of meta-analyses indicate the high efficiency and good tolerability of agomelatine, an antidepressant with an innovative mechanism of action, in a wide range of patients

About the Authors

V. E. Medvedev
Medical Institute, Peoples' Friendship University of Russia
Russian Federation

Vladimir Ernstovich Medvedev

Department of Psychiatry, Psychotherapy, and Psychosomatic Pathology, Faculty of Advanced Training of Medical Workers

6, Miklukho-Maklai St., Moscow 117198

E. A. Korovyakova
Medical Institute, Peoples' Friendship University of Russia
Russian Federation

Department of Psychiatry, Psychotherapy, and Psychosomatic Pathology, Faculty of Advanced Training of Medical Workers

6, Miklukho-Maklai St., Moscow 117198

V. I. Frolova
Medical Institute, Peoples' Friendship University of Russia
Russian Federation

Department of Psychiatry, Psychotherapy, and Psychosomatic Pathology, Faculty of Advanced Training of Medical Workers

6, Miklukho-Maklai St., Moscow 117198

E. V. Gushanskaya
Medical Institute, Peoples' Friendship University of Russia
Russian Federation

Department of Psychiatry, Psychotherapy, and Psychosomatic Pathology, Faculty of Advanced Training of Medical Workers

6, Miklukho-Maklai St., Moscow 117198


1. Artyukhova MG. Depression and anxiety in cardiac patients. Russkii meditsinskii zhurnal. 2008;(12):1724-7. (In Russ.)]

2. .2. Vasyuk YuA, Dovzhenko TV, Shkol'nik EL, Yushchuk EV. Depressiya i khronicheskaya serdechnaya nedostatochnost' pri serdechno-sosudistykh zabolevaniyakh [Depression and chronic heart failure in cardiovascular diseases]. Moscow: Anakharsis; 2008. 288 p.

3. Vasyuk YuA, Lebedev AB, Dovzhenko TV, Semiglazova MV. Affective disorders and myocardial infarction: clinical and functional relationships and possibilities of antidepressant therapy. Kardiologiya. 2009;(1):25-9. (In Russ.).

4. Belenkov YuN, Oganov RG, editors. Kardiologiya. Natsional'noe rukovodstvo [Cardiology. National guidelines]. Moscow: GEOTAR-Media; 2007. P. 1141-70.

5. Medvedev VE. Depressii pri serdechno-sosudistykh zabolevaniyakh (uchebno-metodicheskoe posobie) [Depression in cardiovascular diseases (training manual)]. Moscow: Sinaps; 2018. 92 p.

6. Oganov RG, Ol'binskaya LI, Smulevich AB. Depression and depressive spectrum disorders in general medical practice. Preliminary results of COMPASS program. Kardiologiya. 2004;(1): 48-55. (In Russ.).

7. Medvedev VE. Mental disorders and hypertension (literature review). Psikhicheskie rasstroistva v obshchei meditsine. 2007;(1):33-9. (In Russ.).

8. Smulevich AB, Syrkin AL, Drobizhev MYu, Ivanov SV. Psikhokardiologiya [Psychocardiology]. Moscow: MIA; 2005. 784 p.

9. Chazov EI, Oganov RG, Pogosova GV. Coordinate program (Clinical and epidemiological program for the study of depression in cardiological practice in patients with arterial hypertension and coronary heart disease): results of the therapeutic part of the multicenter study. Terapevticheskii arkhiv. 2006;(4):38–43. (In Russ.).

10. Kopylov FYu, Syrkin AL, Drobizhev MYu, et al. Clinical and psychosomatic peculiarities of hypertensive disease under conditions of chronic stress. Klinicheskaya meditsina. 2008;(2):23-6. (In Russ.).

11. Medvedev VE, Kopylov FYu, Trosnova AP, et al. Psychosomatic correlations in crisis of hypertension disease. Psikhicheskie rasstroistva v obshchei meditsine. 2007;(1):10-3. (In Russ.).

12. Medvedev VE, Martynov SE, Zverev KV, et al. Psychosomatic diseases in cardiology (typology, clinical and dynamic characteristics). Psikhiatriya i psikhofarmakoterapiya. 2012;(4): 34-41. (In Russ.).

13. Petrova NN, Kutuzova AE. Psychosomatic aspects of chronic heart failure. Psikhicheskie rasstroistva v obshchei meditsine. 2011;(2):23-8. (In Russ.).

14. Syrkin AL, Medvedev VE, Kopylov FYu, Visurov SA. Influence of pathocharacterological disorders on the course of hypertension. Vrach. 2007; (4):10-2. (In Russ.).

15. Syrkin AL, Kopylov FYu, Popova EA, et al. Mental disorders at different stages of atrial fibrillation. Psikhicheskie rasstroistva v obshchei meditsine. 2007;(4):10-4. (In Russ.).

16. Aquarius AE. Type-D Personality and Ankle Brachial Index as Predictors of Impaired Quality of Life and Depressive Symptoms in Peripheral Arterial Disease. Arch Surg. 2007 Jul; 142(7):662-7.

17. Karlsson MR, Edströ m-Plü ss C, Held C, et al. Effects of expanded cardiac rehabilitation on psychosocial status in coronary artery disease with focus on type D characteristics. J Behav Med. 2007 Jun;30(3):253-61. Epub 2007 Apr 7.

18. Kupper N, Denollet J, de Geus EJ, et al. Heritability of Type-D Personality. Psychosom Med. 2007 Sep-Oct;69(7):675-81. Epub 2007 Aug 31.

19. Liu H, Saijo Y, Zhang X, et al. Impact of Type A Behavior on Brachial-Ankle Pulse wave velocity in Japanese. Tohoku J Exp Med. 2006 May;209(1):15-21.

20. Pedersen SS, Spindler H, Johansen JB, Mortensen PT. Clustering of Poor Device Acceptance and Type D Personality is Associated with Increased Distress in Danish Cardioverter-Defibrillator Patients. Pacing Clin Electrophysiol. 2009 Jan;32(1):29-36. doi: 10.1111/j.1540-8159.2009.02173.x.

21. Schiffer AA, Denollet J, Widdershoven JW, et al. Failure to consult for symptoms of heart failure in patients with a type-D personality. Heart. 2007 Jul;93(7):814-8. Epub 2007 Mar 7.

22. Service HM, Hintsanen M, Hintsa T, et al. Does neuregulin-1 play a role in Type A behavior? The cardiovascular risk in young Finns study. Behav Brain Funct. 2008 Sep 17;4:40. doi: 10.1186/1744-9081-4-40.

23. Sogaard AJ, Dalgard OS, Holme I, et al. Associations between type A behaviour pattern and psychological distress 28 years of follow-up of the Oslo Study 1972/1973. Soc Psychiatry Psychiatr Epidemiol. 2008 Mar;43(3):216-23. Epub 2007 Dec 14.

24. Spindler H, Pedersen SS, Serruys PW, et al. Type-D personality predicts chronic anxiety following percutaneous intervention in the drugeluting stent era. J Affect Disord. 2007 Apr;99 (1-3):173-179. doi: 10.1016/j.jad.2006.09.009

25. Van Gestel YR, Pedersen SS, Van de Sande M, et al. Type-D personality and depressive symptoms predict anxiety 12 months post-percutaneous coronary intervention. J Affect Disord. 2007 Nov;103(1-3):197-203. Epub 2007 Mar 7. doi: 10.1016/j.jad.2007.01.030

26. Suslina ZA, Fonyakin AV. Prakticheskaya kardionevrologiya [Practical cardioneurology]. Moscow: IMA-PRESS; 2010. 204 p.

27. Dickens C, McGowan L, Percival C, et al. Depression is a risk factor for mortality after myocardial infarction: fact or artifact? J Am Coll Cardiol. 2007 May 8;49(18):1834-40. Epub 2007 Apr 20.

28. Graham I, Atar D, Borch-Johnsen K, et al; European Society of Cardiology (ESC) Committee for Practice Guidelines (CPG). European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Eur Heart J. 2007 Oct;28(19):2375-414. Epub 2007 Aug 28.

29. The world health report: health systems financing: the path to universal coverage. WHO; 2010

30. Lange HW, Herrmann-Lingen C. Depressive symptoms predict recurrence of atrial fibrillation after cardioversion. J Psychosom Res. 2007 Nov;63(5):509-513. doi: 10.1016/j.jpsychores.2007.07.010

31. Pedersen SS, Denollet J, Van Gestel YR, et al. Clustering of psychosocial risk factors enhances the risk of depressive symptoms 12-months post-PCI. Eur J Cardiovasc Prev Rehabil. 2008 Apr;15(2):203-9. doi: 10.1097/HJR.0b013e3282f19d2f.

32. Vieweg WV, Wood MA, Fernandez A, et al. Proarrhythmic risk with antipsychotic and antidepressant drugs: implications in the elderly. Drugs Aging. 2009;26(12):997-1012. doi: 10.2165/11318880-000000000-00000.

33. Wilhelmsen L, Welin L, Svä rdsudd K, et al. Secular changes in cardiovascular risk factors and attack rate of myocardial infarction among men aged 50 in Gothenburg, Sweden. Accurate prediction using risk models. J Intern Med. 2008 Jun;263(6):636-43. doi: 10.1111/j.1365-2796.2008.01931.x. Epub 2008 Feb 20.

34. Smulevich AB, Medvedev VE, Frolova VI. Rhythms of depression in endogenous and somatic (dermato- and cardiological) diseases. Psikhicheskie rasstroistva v obshchei meditsine. 2008;(1):22-5. (In Russ.).

35. Chen S, Duan Q, Tang K, et al. Serotonin and catecholaminergic polymorphic ventricular tachycardia: a possible therapeutic role for SSRIs? Cardiovasc J Afr. 2010 Jul-Aug;21(4): 225-228. doi: 10.5830/cvja-2010-023

36. Lovallo WR, Gerin W. Psychophysiological reactivity: mechanisms and pathways to cardiovascular disease. Psychosom Med. 2003 JanFeb;65(1):36-45. doi: 10.1097/01.psy.0000033128.44101.c1

37. Medvedev VE, Chobanu IK, Frolova VI, et al. Efficiency of psychopharmacotherapy and psychotherapy in patients with cardiovascular diseases. Arkhiv vnutrennei meditsiny. 2013;(5):61-6. (In Russ.).

38. Dovzhenko TV, Tarasova KV, Krasnov VN. The effectiveness of treatment of affective disorders in patients with various cardiovascular diseases. 2007;(4):4-8. (In Russ.).

39. Semiglazova MV, Dovzhenko TV, Krasnov VN, Lebedev AV. Clinical and dynamic features of affective spectrum disorders and efficacy of complex therapy (antiplatelets, betablockers, ACE inhibitors and tianeptine) in patients after acute myocardial infarction. Psikhicheskoe zdorov'e. 2008;(6):33-9. (In Russ.).

40. Tsygankov BD, Chazova IE, Polyakova EO. Differentiated therapy of depressive disorders in patients with hypertension and metabolic disorders. Sibirskii vestnik psikhiatrii i narkologii. 2007;(1):52-7. (In Russ.).

41. Medvedev VE. Efficacy and tolerability of modern antidepressants: results of network meta-analyses and Russian experience. Zhurnal nevrologii i psikhiatrii im. S.S.Korsakova. 2018; 118(11):109-17. (In Russ.).

42. Frolova VI. Data review of network meta-analysis on the effectiveness of new generation antidepressants. Psikhiatriya i psikhofarmakoterapiya. 2016;18(6): 21–5. (In Russ.).

43. Frolova VI. Comparative effectiveness of modern antidepressants: data of network metaanalyses. Psikhiatriya i psikhofarmakoterapiya. 2018;20(6):9–13. (In Russ.).

44. Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet. 2018 Apr 7;391(10128):1357-1366. doi: 10.1016/S0140-6736(17)32802-7. Epub 2018 Feb 21.

45. Demyttenaere K, Corruble E, Hale A, et al. A pooled analysis of six month comparative efficacy and tolerability in four randomized clinical trials: agomelatine versus escitalopram, fluoxetine, and sertraline. CNS Spectr. 2013 Jun;18(3): 163-70. doi: 10.1017/S1092852913000060. Epub 2013 Mar 11.

46. Khoo AL, Zhou HJ, Teng M, et al. Network Meta-Analysis and Cost-Effectiveness Generation Antidepressants. CNS Drugs. 2015 Aug;29(8):695-712. doi: 10.1007/s40263-015-0267-6.

47. Taylor D, Sparshatt A, Varma S, Olofinjana O. Antidepressant efficacy of agomelatine: metaanalysis of published and unpublished studies. BMJ. 2014 Mar 19;348:g1888. doi: 10.1136/bmj.g1888.

48. Golovacheva TV, Skvortsov VV, Skvortsov KYu. On the safety of antidepressants in cardiological practice (review of foreign literature). Psikhicheskie rasstroistva v obshchei meditsine. 2008;(4):51-65. (In Russ.).

49. Czarny MJ, Arthurs E, Coffie DF, et al. Prevalence of antidepressant prescription or use in patients with acute coronary syndrome: a systematic review. PLoS One. 2011;6(11):e27671. doi: 10.1371/journal.pone.0027671. Epub 2011 Nov 22.

50. Medvedev VE. Valdoxan (agomelatine) in combined therapy of moderate and severe non-psychotic depressions. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2012;(5-1):37-40. (In Russ.)].

51. Medvedev VE. Prospects for the use of melatonergic drugs in the treatment of depression in patients with cardiovascular disease. Psikhiatriya i psikhofarmakoterapiya. 2010;(3):19-23. (In Russ.).

52. Medvedev VE, Epifanov AV. Innovative method of treatment of depression in patients with coronary heart disease. Obozrenie psikhiatrii i meditsinskoi psikhologii imeni V.M. Bekhtereva. 2010;(3):31-6. (In Russ.).

53. Medvedev VE, Epifanov AV. Therapy of depression in patients with hypertension in a general medical hospital. Psikhiatriya i psikhofarmakoterapiya. 2012;(5): 14-8. (In Russ.)].

54. Medvedev VE, Epifanov AV, Zverev KV. Preventive and relieving therapy of psychopathological disorders in patients with acute coronary syndrome. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2012; (4):42-8. (In Russ.).

55. Medvedev VE, Retyunskii KYu, Ovchinnikov AA, et al. Differences in the assessment of the severity of depression by doctors and patients in the course of combined therapy with agomelatin (multicenter study " EMOTION»). Zhurnal nevrologii i psikhiatrii im. S.S.Korsakova. 2016; (11):26-34. (In Russ.).

56. Medvedev VE, Ter-Israelyan AYu, Frolova VI, et al. Experience with valdoxan in depression, occurring with cognitive impairment. Zhurnal nevrologii i psikhiatrii im. S.S.Korsakova. 2018;(2):77-80. (In Russ.).

57. Medvedev VE, Frolova VI, Epifanov AV. New possibilities of pharmacotherapy in cardiovascular patients with mental disorders. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2014;(9):30-7. (In Russ.).

58. Chernova EV, Kozhechkina OV, Ter-Israelyan AYu, Medvedev VE. Agomelatine (Valdoxan) in treatment of endogenous depres sion in day patient department. Zhurnal nevrologii i psikhiatrii im. S.S.Korsakova. 2016; (10):43-6. (In Russ.).

59. Medvedev VE. Use of valdoxan (Agomelatin) in the combined treatment of moderate and severe nonpsychotic depression Neuroscience and Behavioral Physiology. 2013; 43(7):878-82. doi: 10.1007/s11055-013-9822-0

60. Medvedev VE. Agomelatine in the treatment of mild-to-moderate depression in patients with cardiovascular disorders: results of the National Multicenter Observational Study PULSE. Neuropsychiatr Dis Treat. 2017 Apr 21; 13:1141-1151. doi: 10.2147/NDT.S129793. eCollection 2017.

61. Medvedev VE, Retyunskii KY, Ovchinnikov AA, et al. Differences in Assessment of the Severity of Depression by Doctors and Patients during Combined Therapy with Agomelatine (the EMOTION multicenter trial). Neuroscience and Behavioral Physiology. 2018;48(3):367-76. doi: 10.1007/s11055-018-0572-x

For citation:

Medvedev V.E., Korovyakova E.A., Frolova V.I., Gushanskaya E.V. Antidepressant therapy in patients with cardiovascular diseases. Neurology, Neuropsychiatry, Psychosomatics. 2019;11(1):131-140. (In Russ.)

Views: 431

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)