Are antidepressants safe if you have a heart condition?

Carolyn Chew-Graham, Professor of General Practice Research at Keele University and expert in mental health, shares her view on treating people with depression and a heart condition.

Many antidepressants are indeed safe to take even if you have a heart condition.

Depression is a common experience for many people with and without long-term health conditions. It can make you feel hopeless, constantly tired, or like nothing can bring you joy or pleasure. It can also make it harder to look after your physical wellbeing and to recover from a heart condition or another illness.

But depression often improves over time with the right approach. You need to find one that’s right for you. For mild depression, you may benefit from talking therapies, staying active and eating healthily. Antidepressants can help if you have moderate to severe depressive symptoms, or if they helped you in the past.

Sertraline is the recommended first-choice antidepressant, and can be used if you have heart disease. Citalopram and escitalopram, which are a similar type of drug, are generally safe to take, although higher doses can affect your heart and may lead to abnormal heart rhythms. Your doctor would need to monitor your heart carefully and, in some cases, would make changes to your antidepressant treatment.

Sign up to our fortnightly Heart Matters newsletter to receive tips on coping with difficult emotions, looking after your health and living well. Joining is free and takes two minutes.

More people are taking antidepressants today than in the past, and treatment tends to be longer. But we know little about the impact of long-term antidepressant use. Your GP should regularly review whether you still need antidepressants and at what dose. This is even more important as you get older, when you may need multiple medications. The moredrugs you take, the greater the risk of side-effects and drug interactions.

Still, antidepressants are generally safe for people with heart conditions, so have an open mind if you are offered one. At the same time, consider other things that you can help you recover from depression.

Stay active within your abilities, and participate in cardiac rehabilitation, if it’s offered. Cardiac rehab allows you to work with physiotherapists and other specialists who support both your physical and psychological recovery.

Stopping smoking, cutting down on alcohol and eating healthily can also help improve your physical and mental health. Speak to your GP or practice nurse about any lifestyle changes you’d like to make and ask what support they can give you.

Referring yourself to NHS Talking Therapies, leaning on your friends and family, and joining activity groups in your local area can also be helpful. Yoga and mindfulness can also help improve your general health and your mood.

Carolyn Chew-Graham is a Professor of General Practice Research at Keele University and a GP in Manchester. Her expertise includes the primary care management of people with mental health problems, multiple health conditions and unexplained symptoms.

Published September 2023

Read the article