Study suggests anti-depressant is safe in some heart patients

Tuesday, August 13th 2002, 12:00 am
By: News On 6

CHICAGO (AP) _ The popular anti-depressant Zoloft appears to be safe and effective for heart attack patients, a company-sponsored study suggests.

Researchers found that Zoloft caused no more chest pain, heart rate abnormalities or irregular heartbeats than dummy pills. Zoloft patients even appeared to have fewer life-threatening events such as recurrent heart attacks, heart failure and strokes, though those results were not statistically significant.

The drug, as expected, also reduced depression. Researchers said its effects in heart attack survivors had not been demonstrated previously.

Zoloft maker Pfizer Inc. helped fund the study, and a Pfizer employee was involved in the study design and analysis. The results appear in Wednesday's Journal of the American Medical Association.

Older drugs known as tricyclic antidepressants in some patients have been linked with heart problems including arrhythmia and heart attacks, especially in high doses. Some tricyclics, including imipramine and amitriptyline, are not recommended for use in patients with recent heart attacks.

Enrollment in the latest study began in 1997, a year after the Food and Drug Administration warned Pfizer against marketing Zoloft for heart attack patients because of concerns that it might cause chest pain and a rapid heartbeat.

The findings are significant because about 20 percent of the more than 1 million Americans who have heart attacks each year will also experience major depression.

Those who do develop depression are nearly three times more likely to die prematurely than heart attack survivors who aren't depressed, said lead researcher Dr. Alexander Glassman of the New York State Psychiatric Institute.

The study included patients who'd had heart attacks an average of about four weeks before starting the drug.

It excluded severely medically ill patients and those for whom drugs like Zoloft are not recommended. Thus, the results cannot be generalized to all heart attack patients, according to an accompanying editorial by Drs. Robert Carney and Allan Jaffe.

Still, they called the study ``a major step forward in the care of depressed patients with coronary heart disease.''

Carney, of Washington University School of Medicine, and Jaffe, of the Mayo Clinic, were not involved in the research.

The study involved 369 depressed patients in the United States, Canada, Europe and Australia. All had suffered recent heart attacks or severe chest pain called unstable angina and took Zoloft or a placebo for 24 weeks.

American Heart Association spokesman Dr. Sidney Smith said larger studies confirming the results should be done before Zoloft is routinely recommended for depressed heart attack survivors.

Zoloft belongs to a newer class of antidepressants called selective serotonin reuptake inhibitors, which also include Prozac and Paxil. Whether the results apply to SSRI drugs other than Zoloft is not known, the editorial says.