Antidepressants use with Ischemic Heart Disease?

It is well known that ischemic heart disease (IHD) can increase the risk of depression but depression can also increase the risk of IHD. It is important to monitor for depression in patients with IHD, particularly the patients recovering from an acute ischemic event such as myocardial infarction. On top of that, untreated depression can complicate the recovery of IHD.

The depression can be effectively treated with antidepressants, but understanding the drug interactions between antidepressants and cardiac medications is clinically relevant for practicing medical professionals. 

Let’s begin by answering this question first:

Which of the following antidepressant should be avoided in patient with ischemic heart disease on clopidogrel?

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Answer: Fluoxetine and Fluvoxamine are best avoided in Ischemic heart disease patients who are receiving clopidogrel because both antidepressants may diminish the efficacy of clopidogrel.

  • Mechanism: CYP2C19 inhibition

Academy members will have access to the following chapter:

Drug Interactions: Antidepressants & Cardiac Medications

This academy chapter will discuss the antidepressants that carries the risk of drug interactions with:

  • Beta-Blockers: Propranolol, Metoprolol, Timolol & Carvedilol
  • Captopril
  • Calcium channel blockers
  • Amiodarone
  • HMG CoA Reductase Inhibitors: atorvastatin, lovastatin & simvastatin 
  • Quinidine
  • Clopidogrel

Antidepressants & Cardiac Medications



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  • Essentials of Inpatient Psychiatry Book: All chapters from this book are included in the academy sections. 
  • Goal: is to have all important clinically relevant topics in one place for ease of access.


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