Depression and myocardial infarction: implications for medical prognosis and options for treatment

Mental depression and myocardial infarction (MI) are closely related. The current paper reviews pathophysiological mechanisms that could link depression to MI and discusses the pros and cons of different pharmacological and non-pharmacological treatment modalities that could be considered. The selective serotonin reuptake inhibitors lack arrhythmogenic effects, and have a beneficial effect in addition to depression on psychological factors, such as anxiety and mood disturbances, which are not uncommon in post-MI patients. Studies to further determine the impact of depression on the outcome of MI, and the place of different treatment modalities are in progress. (C) 1998 Elsevier Science B.V.