 |
|
Platelet Reactivity in Depressed Patients Treated With Paroxetine
Preliminary Findings
Dominique L. Musselman, MD;
Ulla M. Marzec;
Amita Manatunga, PhD;
Suzanne Penna, BA;
Andrea Reemsnyder, BS;
Bettina T. Knight, BSN;
Aimee Baron, BA;
Stephen R. Hanson, PhD;
Charles B. Nemeroff, MD, PhD
Arch Gen Psychiatry. 2000;57:875-882.
Background Alterations in platelet reactivity have been previously posited to underlie the increased vulnerability of patients with depression to ischemic heart disease (IHD). The present study sought to determine whether the increased platelet reactivity associated with major depression is reduced after antidepressant treatment.
Methods Patients diagnosed as having DSM-IV major depression (n = 15) (mean age, 37 ± 7 years; range, 23-48 years) and 12 normal comparison subjects (mean age, 36 ± 7; range, 23-48 years) were recruited. None of the controls or depressed group had evidence of IHD; 10 of 15 patients who were depressed had 1 or more traditional IHD risk factors. In vivo platelet activation, secretion, and dose-response aggregation of the controls and patients was measured after overnight bedrest under basal conditions, and after a mild exercise challenge. After 6 weeks of open-label treatment with the selective serotonin reuptake inhibitor paroxetine (20 mg/d), the patients with depression were readmitted and procedures of the first General Clinical Research Center admission repeated.
Results In comparison with the control group, the depressed group exhibited greater procoagulant activity as detected by increased platelet binding of the monoclonal antibodies anti–ligand-induced binding site and GA6, and increased plasma concentrations of platelet factor 4 under basal conditions. After paroxetine treatment, the patients with depression exhibited significant reductions in all 3 parameters.
Conclusions Normalization of platelet activation is associated with paroxetine treatment of patients with depression. Because this study design did not allow for the determination of whether this effect of paroxetine on platelet function is caused by a direct effect of the drug or placebo or, alternatively, because of recovery from depression, studies containing a placebo and/or psychotherapy treatment arm may resolve this issue.
From the Departments of Psychiatry and Behavioral Sciences (Drs Musselman and Nemeroff and Mss Penna, Reemsnyder, Knight, and Baron) and Biomedical Engineering (Ms Marzec and Dr Hanson), School of Medicine, and the Department of Biostatistics, Rollins School of Public Health (Dr Manatunga), Emory University, Atlanta, Ga.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Platelet Thromboxane A2 Secretion in Patients With Major Depression Responsive to Electroconvulsive Therapy
Bruce et al.
Psychosom. Med. 2008;70:319-327.
ABSTRACT
| FULL TEXT
Risk of Cerebrovascular Events Associated with Antidepressant Use in Patients with Depression: A Population-Based, Nested Case-Control Study
Chen et al.
The Annals of Pharmacotherapy 2008;42:177-184.
ABSTRACT
| FULL TEXT
Antidepressants and the Risk of Suicide, Attempted Suicide, and Overall Mortality in a Nationwide Cohort
Tiihonen et al.
Arch Gen Psychiatry 2006;63:1358-1367.
ABSTRACT
| FULL TEXT
Does Treating Post-Myocardial Infarction Depression Reduce Medical Mortality?
Glassman
Arch Gen Psychiatry 2005;62:711-712.
FULL TEXT
Effects of Antidepressant Medication on Morbidity and Mortality in Depressed Patients After Myocardial Infarction
Taylor et al.
Arch Gen Psychiatry 2005;62:792-798.
ABSTRACT
| FULL TEXT
Depression, Alterations in Platelet Function, and Ischemic Heart Disease
Bruce and Musselman
Psychosom. Med. 2005;67:S34-S36.
ABSTRACT
| FULL TEXT
Lessons From SADHART, ENRICHD, and Other Trials
Joynt and O'Connor
Psychosom. Med. 2005;67:S63-S66.
ABSTRACT
| FULL TEXT
Psychiatry and Cardiovascular Disease
Schulman et al.
Focus 2005;3:208-224.
ABSTRACT
| FULL TEXT
The Association Between Major Depression and Levels of Soluble Intercellular Adhesion Molecule 1, Interleukin-6, and C-Reactive Protein in Patients With Recent Acute Coronary Syndromes
Lesperance et al.
Am. J. Psychiatry 2004;161:271-277.
ABSTRACT
| FULL TEXT
Increased susceptibility to ventricular arrhythmias in a rodent model of experimental depression
Grippo et al.
Am. J. Physiol. Heart Circ. Physiol. 2004;286:H619-H626.
ABSTRACT
| FULL TEXT
Psychotropic medication and the heart
O'Brien and Oyebode
Adv. Psychiatr. Treat. 2003;9:414-423.
ABSTRACT
| FULL TEXT
Increased Coronary Events in Depressed Cardiovascular Patients: 5-HT2A Receptor as Missing Link?
Schins et al.
Psychosom. Med. 2003;65:729-737.
ABSTRACT
| FULL TEXT
Platelet/Endothelial Biomarkers in Depressed Patients Treated With the Selective Serotonin Reuptake Inhibitor Sertraline After Acute Coronary Events: The Sertraline AntiDepressant Heart Attack Randomized Trial (SADHART) Platelet Substudy
Serebruany et al.
Circulation 2003;108:939-944.
ABSTRACT
| FULL TEXT
Depression and Coronary Heart Disease in Women With Diabetes
Clouse et al.
Psychosom. Med. 2003;65:376-383.
ABSTRACT
| FULL TEXT
Influence of Serotonin-Transporter-Linked Promoter Region Polymorphism on Platelet Activation in Geriatric Depression
Whyte et al.
Am. J. Psychiatry 2001;158:2074-2076.
ABSTRACT
| FULL TEXT
Selective Serotonin Reuptake Inhibitors and Myocardial Infarction
Sauer et al.
Circulation 2001;104:1894-1898.
ABSTRACT
| FULL TEXT
Depression in Patients Recovering From a Myocardial Infarction
Ziegelstein
JAMA 2001;286:1621-1627.
ABSTRACT
| FULL TEXT
Depressive Disorder, Dysthymia, and Risk of Stroke: Thirteen-Year Follow-Up From the Baltimore Epidemiologic Catchment Area Study
Larson et al.
Stroke 2001;32:1979-1983.
ABSTRACT
| FULL TEXT
|
