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Background: Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and venlafaxine have the potential to exert beneficial effects on the heart via serotonin mediated antiplatelet activity. However, previous evidence regarding the cardiovascular effects of these agents has been conflicting. There is a need for further investigation into the risks and benefits of these drugs. Objective: To assess the risk of acute MI and cardiac death associated the use of various classes of antidepressants, and determine whether this risk is modified by the presence of predisposing factors. Methods: We identified a population-based, retrospective cohort study of 71,253 elderly persons initiating treatment with an antidepressant between 1997 and 2004. The cohort was analyzed using nested case-control approach with each case of acute MI or cardiac death matched with up to 20 controls according to age (±1 year), duration of follow-up, and year of cohort entry. Rate ratios for acute MI and cardiac death associated with the current use of various antidepressants were estimated using conditional logistic regression and adjusted for potential confounders. Results: Compared with the current use of atypical antidepressants, current use of venlafaxine was associated with a significant reduction in the risk of MI and cardiac death (rate ratio [RR] 0.80 [95% CI 0.66 to 0.97]) that was more pronounced in persons with established cardiovascular disease (CVD) (RR 0.65 [CI 0.50 to 0.86]). We found no clear evidence of a benefit or harm associated with the use of SSRIs (RR 0.92 [CI 0.79 to 1.06]), although there was the suggestion of a clinically important benefit from treatment with SSRIs for individuals who had history of MI (RR 0.68 [CI 0.44 to 1.07]). No benefit or harm was observed with other classes of antidepressants. Conclusions: These results demonstrate a reduced risk for acute MI and cardiac death associated with current use of venlafaxine among elderly persons. This beneficial effect appears to be more pronounced in those with established cardiovascular disease. No clear evidence of benefit on CV outcomes was associated with the current use of SSRIs, although results suggest a potential benefit for use in persons with a previous MI. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2007-09-04 14:46:14.571

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Thesis (M.S.) -- Central Connecticut State University, 2003. / Thesis advisor: Cheryl Watson. "... for the degree of Master of Science, Department of Biology." Includes bibliographical references (leaves 35-40). Also available via the World Wide Web.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1982. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 98-109).

It has been recorded that women respond to tricyclic antidepressives with a greater incidence of anticholinergic side effects than men do, particularly women taking an exogenous source of oestrogen. The aim of this study was to investigate the influence that ethinyl oestradiol and Premarin© had on the metabolism of a number of tricyclic antidepressives, and also the influence they had on the binding ability of microsomes to imipramine. Rat hepatocyctes and microsomes were used. Detection techniques used were High Pressure Liquid Chromatography and Spectrophotometry respectively. In addition to these studies, a study of the anticholinergic activity of Nomifensine, tricyclic antidepressives and their derivatives was performed on a rat jujenum. Results conclusively showed that ethinyl oestradiol had a marked influence on the metabolism of the tricyclic antidepressives studied. Premarin© had Iittle, if any influence. However, both ethinyl oestradiol and Premarin© affected the binding of microsomes to imipramine, but ethinyl oestradiol had the greater effect. The parent compound in each case exhibited a higher pAZ value. Results indicate that a possible explanation for the increased anticholinergic side effect is due to an inhibition of the metabolism of the tricyclic antidepressives by oestrogen.