The potential “protective” role of SSRI in postinfarction, major depressive patients: a case-report

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Sergio Ruiz-Doblado
Ángela Ruiz-Arcos
Alicia Quirós-López

In the last years, Major-Depression (MD) without a correct diagnosis or treatment has acquired a significative role as an independent coronary risk factor, similar to the classical vascular risk factors. Therefore, it is necessary a praecox diagnosis and treatment of MD performed by psychiatrist or clinical psychologist, in the setting of multidisciplinary hospital teams of Cardiac Rehabilitation. We presented a case-report of melancholic, Major Depression (MD) post-myocardial infarction, successfully treated with SSRI (ciatalopram). Focused on this
case-report, the discussion is directed to the security, efficacy and potential “protective” action of these drugs (SSRI) in coronary patients: Action on neuroinflammatory pathways mediated by MD; antithrombogenic effect of SSRI mediated by platelets´ 5-HT; reduction of cellular apoptosis in both hippocampal cells and myocardiocyte in experimental, animal models of MD; security of SSRI in anticoagulated patients but caution in antiaggregated ones (Clopidogrel or double antiaggregation) combined with fluvoxamine and fluoxetine (CYP2C19 metabolim); and improvement of cardiac functionalism variables by an independent mechanism of SSRI antidepressant action.

Keywords
Major-Depression, Acute-Myocardial-Infarction, Cardiac-Rehabilitation, Selective-Serotonin-Reuptake- Inhibitors (SSRI)

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How to Cite
Ruiz-Doblado, Sergio et al. “The potential ‘protective’ role of SSRI in postinfarction, major depressive patients: a case-report”. Psicosomàtica y Psiquiatría, no. 13, doi:10.34810/PsicosomPsiquiatrnum1307.