Table 1.

Randomised double blind studies using selective serotonin reuptake inhibitors for psychiatric morbidity in patients with cardiovascular disease

Trial	Psychiatric morbidity	Cardiovascular morbidity	Drugs	No of patients	Cardiovascular adverse effects	Cardiovascular benefit	Psychiatric outcome
Glassman et al (SADHART) 200214	Major depression*	Myocardial infarction or angina	Sertraline v placebo	369	No significant difference	Non-significant trend, suggesting sertraline protective against subsequent events	Sertraline superior to placebo for most depression outcomes
McFarlane et al 200115	Major and minor depression by standard questionnaire	Myocardial infarction	Sertraline v placebo	27	Decreased heart rate variability with placebo	Increased heart rate variability with sertraline	Sertraline superior to placebo on depression scores
Strik et al 200016	Major depression†	Myocardial infarction	Fluoxetine v placebo	54	No significant difference	Non-significant trend, suggesting fluoxetine reduced readmission to hospital for cardiac events	Fluoxetine superior to placebo for most depression outcomes
Roose et al 199812	Major depression†	Ischaemic heart disease	Paroxetine v nortriptyline	81	Increased heart rate and decreased heart rate variability with nortriptyline. Significant excess of withdrawals in nortriptyline group due to adverse cardiovascular events (17% v 0%)	—	Paroxetine slightly but not significantly superior to nortriptyline in treatment of depression
Strik et al 199817	Major depression*	Nil (n=13), myocardial infarction (n=5), and hypertension (n=2)	Fluoxetine v fluvoxamine	20	No significant difference	Ejection fraction improved by both drugs in patients with cardiovascular disease	Both drugs effective in treating depression
Fruehwald et al 200318	Moderate to severe depression by standard questionnaire	Stroke	Fluoxetine v placebo	50	No cardiovascular effects reported	—	Improvement in depression scores at four weeks in both groups. Fluoxetine superior in open label follow up
Wiart et al 200019	Major depression*	Stroke causing hemiplegia	Fluoxetine v placebo	31	No significant cardiovascular effects reported	—	Fluoxetine significantly more effective than placebo for depression
Robinson et al 200020	Major or minor depression*	Stroke	Fluoxetine v nortriptyline v placebo	56	Increase in heart rate significantly greater in nortriptyline group than placebo group	—	Nortriptyline significantly more effective than fluoxetine and placebo for depression and anxiety symptoms
Dam et al 199621	Depression by standard questionnaire (severity not stated)	Stroke causing hemiplegia	Fluoxetine v maprotiline v placebo	52	No cardiovascular effects reported; fluoxetine group superior to maprotiline and placebo groups in functional indices	—	Fluoxetine and maprotiline associated with significant improvement in depression
Andersen et al 199422	Moderate to severe depression by standard questionnaire	Stroke	Citalopram v placebo	66	No serious cardiovascular side effects reported	—	Better outcome in citalopram group

^*Diagnostic and Statistical Manual of Mental Disorders, fourth edition.

^†Diagnostic and Statistical Manual of Mental Disorders, third edition, revised.