Heart Patients Prone to Depression (Part 2)

1. Trouble falling asleep, staying asleep, or sleeping too much
2. Feeling tired or having little energy
3. Poor appetite or overeating
4. Feeling bad about yourself, that you are a failure, or that you have let yourself or your family down
5. Trouble concentrating on things such as reading the newspaper or watching television
6. Moving or speaking so slowly that other people could have noticed or being so fidgety or restless that you have been moving around a lot more than usual
7. Thinking that you would be better off dead or that you want to hurt yourself in some way
Screening could take place in a variety of medical settings; at the hospital, doctors’ office, clinic or cardiac rehabilitation centers. If depression is indicated, the patient may be referred to a professional qualified in treating the condition. Treatment strategies for patients with coronary disease and depression include antidepressant drugs, behavioral therapy, and exercise or a combination. The antidepressants Zoloft, sold as the generic sertraline, and Celexa, sold as generic citalopram, are considered good first-line therapies, as research has shown they are generally safe for cardiac patients.

These guidelines could potentially affect millions of Americans, including 16 million who have heart disease and 8.1 million who have suffered a heart attack. Erika Froelicher, RN, MPH, PHD, professor of nursing and epidemiology and statistics at the University of California, San Francisco and co-chair of the group that created the recommendations, said the hope is that routine screening for depression will be done on every cardiac patient. “I believe a lot of depressed cardiac patients are overlooked,” she said. “Unless you screen formally, you can miss a lot of people.”

The American Psychiatric Association endorsed the new recommendations, which were published online in advance of the October 21 issue of Circulation: Journal of the American Heart Association.