Depression in the medically ill: Management considerations

Dwight L. Evans, Jeffrey Staab, Herb Ward, Jane Leserman, Diane O. Perkins, Robert N. Golden, John M. Petitto

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

This article reviews the management of depression in three medical conditions associated with a high frequency of depression: coronary artery disease (CAD), cancer, and human immunodeficiency virus (HIV) injection. Major depression significantly increases mortality in patients with CAD. This effect of depression may be mediated by a decrease in heart rate variability. Tricyclic antidepressants (TCAs) possess Type 1A antiarrhythmic activity, which may increase the risk of sudden death. Initial data suggest that tricyclic antidepressants also may decrease heart rate variability. Antidepressant therapy is effective and can improve quality of life for patients with cancer or HIV infection. Strong social support or psychosocial interventions that improve coping skills may positively affect outcome in HIV injection and cancer. Selective serotonin reuptake inhibitors (SSRIs) and new agents may be well suited for use in depressed patients with medical illnesses because they lack the significant adverse anticholinergic and cardiovascular effects of TCAs and other classes of antidepressants.

Original languageEnglish (US)
Pages (from-to)199-208
Number of pages10
JournalDepression and Anxiety
Volume4
Issue number4
DOIs
StatePublished - 1996

Keywords

  • AIDS
  • adverse effects
  • cancer
  • coronary artery disease
  • depression
  • human immunodeficiency virus
  • psychotherapy
  • quality of life
  • selective serotonin reuptake inhibitor
  • tricyclic antidepressant

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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