My Adventures with Heart Failure

Another article of interest (I've been on antidepressants since long before I got diagnosed with CHF):

Depression Worsens Outcomes for Heart Failure Patients

March 6 (HealthDay News) -- Depression is a major factor in poor medical outcomes for heart failure patients, says a new U.S. study.
The study, conducted by researchers at Duke University Medical Center and the University of North Carolina, included 204 heart failure patients who were followed for an average of three years. Tests showed that 46 percent of the patients had significant symptoms of depression. During the study period, 26 percent of the patients died, and 48 percent were hospitalized at least once for their heart
condition.
The researchers concluded that patients with depression were more
than 50 percent likely to die or be hospitalized for their heart condition than
patients who weren't depressed. This means that, in heart failure patients, depression ranks in importance with risk factors such as high cholesterol, hypertension and even the ability of the heart to pump blood throughout the body, the study authors said.
"While many studies have linked depression to worse outcomes for patients with heart disease, there has been uncertainty about the extent to which depression is related to the adverse medical outcomes independent of known medical risk factors," study co-author James Blumenthal, a clinical psychologist at Duke, said in a prepared statement.
It's not clear why heart failure patients with depression have worse outcomes. The researchers are launching a new clinical trial to further investigate depression in heart failure patients.
The study was published in the Feb. 26 issue of the Archives of Internal Medicine.

SOURCE: Duke University Medical Center, news release, February 2007

This is especially interesting in light of something my cardiologist told me back when I first got started on Coreg (carvedilol), which is that many people get depression as a side effect of taking beta-blockers until they get fully acclimated to them, and that for that reason while the dose of Coreg is being titrated, which takes weeks, the cardiologist asks questions at every visit intended to detect depression and consider prescribing anti-depressants. So, depression is a side-effect of one of the medications used to treat heart failure, and depression can lead to worse outcomes in heart failure... we're sort of in a catch-22, aren't we!!

This is, of course, NOT a message that you should stop taking your Coreg; for one thing, for most people the benefits of the beta-blocker undoubtedly outweigh the risks, and for another thing, discontinuing any medication suddenly is a bad idea, and especially a bad idea for certain drugs including beta-blockers. Suddenly stopping taking your Coreg could land you in the hospital right quickly. However, if you are taking Coreg and feel fatigued, listless, have trouble concentrating, or have trouble sleeping through the night, these could be signs of depression, and you should ask your doctor about appropriate additional treatment for depression.