Effectiveness of sertraline in treatment of depression in a consecutive sample of patients with acute myocardial infarction: six month prospective study on outcome

BACKGROUND A considerable proportion of patients suffer from depression following acute myocardial infarction. Information regarding this prevalence in Indian patients and response to treatment is lacking. METHOD Prevalence of major depression was studied in 50 consecutive in-patients with acute myocardial infarction following DSM-IV criteria. In a comparative study outcome of treatment with sertraline in terms of recovery from depression, change in Hamilton Depression Rating scale score and occurrence of cardiac events were ascertained for a 6-month period, which were compared with a group of patients who did not receive sertraline. RESULTS Major depression was diagnosed in 34% of patients. Female patients were more affected than the males. Hamilton Depression Rating scale scores gradually decreased in both the groups over the study period; however it became significantly less for patients treated with sertraline. Significantly more number of patients who received sertraline recovered from depression. There were no dropouts due to non-response or side effects. Cardiac events were reported less in this group than those who continued only cardiac treatment as usual. CONCLUSION A considerable proportion of acute myocardial infarction patients have major depression. Sertraline is efficacious and safe in these patients. Antidepressant treatment might be associated with reduction of cardiac events.