Brief report: Characteristics of antidepressant use in patients with heart failure

Paul J Mills¹, Joel E Dimsdale¹, Suzi Hong¹, Geoffrey Van Den Brande², Laura Redwine², Barry H Greenberg², Thomas Rutledge¹

¹Department of Psychiatry; ²Department of Medicine, University of California San Diego, La Jolla, CA, USA

Background: Depression is common in heart failure (HF), but there is little data on the characteristics of antidepressant use in patients with HF.

Objective: To survey basic information on antidepressant prescription characteristics, use, effectiveness, and follow-up.

Methods: Observational study in two outpatient cardiology clinics of 37 NYHA class I–IV HF patients taking antidepressant medication.

Results: Thirty-one percent of prescriptions for antidepressants were obtained from psychiatrists, 58% from primary care physicians, and 8% from cardiologists. The majority of patients (87%) reported regularly taking their antidepressant medication as prescribed, however 48% reported never having had the dosage of their antidepressant medication adjusted. Only 53% of the patients reported that the medication had helped their mood “almost entirely” or “mostly” back to normal since starting their antidepressants, while the remaining patients reported that their mood was only “halfway” or “somewhat” back to normal or that the medication had not helped their depression at all. Among a subset of 10 patients who completed the Beck Depression (BDI) inventory, 6 still had depressed mood (BDI ≥ 10).

Conclusion: The findings from this survey study provide insight into the characteristics of antidepressant use in patients with HF and argue for better follow up of HF patients who are prescribed antidepressants.

Keywords: heart failure, antidepressant medication, adherence, effectiveness