A cardiac event is a frightening occurrence, and it increases the likelihood of further cardiovascular complications. Is there a way to reduce that risk? The antidepressant escitalopram, sold under the brand name Lexapro, has been shown to have benefits for heart patients.
Studying Lexapro after a Cardiac Event:
A randomized placebo-controlled trial in Korea included 300 people who had been diagnosed with depression and acute coronary syndrome (JAMA, July 24/31, 2018). In this cardiac event, blood flow to the heart is suddenly restricted. The victim often reports chest pain, dizziness, shortness of breath or nausea. Acute coronary syndrome is an umbrella term that may include a heart attack or unstable angina. This is a medical emergency and requires immediate treatment. It increases the chances of cardiovascular complications and death in the subsequent months and years.
In this study the patients received either escitalopram or a placebo for half a year. They were tracked for an average of eight years. Those who received escitalopram had fewer cardiovascular complications, although they were no less likely to die.
Why Look at Depression with a Cardiac Event?
Scientists have long known that people who have experienced a cardiac event may become depressed. A review of the medical literature concluded that those with depression are also more susceptible to cardiovascular disease and have worse outcomes (Seligman & Nemeroff, Annals of the New York Academy of Sciences, May 2015). That could help explain the potential benefit from an antidepressant. The link is well established (De Hert et al, Dialogues in Clinical Neuroscience, March 2018). However, the benefits of antidepressant treatment are less clear (Cochrane Database of Systematic Reviews, April 28, 2017). We hope other scientists will follow up on this research with studies to better explain when antidepressants can be useful.
