The Safety, efficacy, and tolerability of pharmacological treatment of depression in patients with cardiovascular disease: A look at antidepressants and integrative approaches

Patients with cardiovascular disease (CVD) are at an increased risk of developing psychiatric illnesses, particularly depression. Depression is an independent risk factor leading to a cardiac event, which has been shown in patients with or without known coronary artery disease (CAD). Treatment of depression has been shown to improve quality of life and result in a better cardiovascular prognosis in patients with comorbid CVD. However, pharmacological treatment of depression in this particular patient population is not without risk and is not always effective. An emerging approach to improve nonresponse to antidepressants is the use of adjunctive nutraceuticals. This article is to review the pharmacological options for treating depression in patients with CAD. The use of integrative approaches and supplements in patients with CVD is also discussed.