Keywords : tricyclic antidepressants
journal of kerbala university,
2006, Volume 2, Issue 2, Pages 102-121
Background: Cholesterol is widely distributed in all tissues, but it is especially abundant in the nervous system, where it is important for many aspects of cellular structure and function. Depression is present in high range in patients admitted to hospital after a myocardial infarction and is an independent risk factor for increased mortality. Cholesterol is one of the risk factor of ischaemic heart diseases (IHD). Any association between depression and cholesterol level is complex and may be confounded by the increase use of antidepressants and other medications among persons with depression.
In this work, an attempt was carried out to link depression, serum cholesterol, and the effect of treatment by measuring serum cholesterol in the tricyclic antidepressants (TCAs) treated depressed patients and compare with control and untreated depressed patients to evaluate the effect of treatment
on serum cholesterol. The second aim of this study is to review the majority of researches that studied serum cholesterol in different categories of depressed patients in different countries.
Patients and Methods: This study included (38) depressed patients who are on TCAs as one of the drugs prescribed for the treatment. The second group consists of seventy two untreated depressed patients. Fifty apparently healthy subjects (no depression and IHD) were selected as a control group. Their sex and age were comparable to those of patients.
Total serum cholesterol was measured by using enzymatic method for the trhree groups under study. Results: There is a significant decrease (p<0.05) in mean serum cholesterol in untreated depressed patients as compared with control or treated depressed patients. While no significant changes noticed from the comparison between treated depressed patients and control group. The results showed that there is a significant difference between males and females in control and untreated depressed patients groups while there is no significant difference in serum cholesterol in between male and female in Treated Depressed Patients.
Conclusion: From the results of this research and the review, it can be concluded that:
Depression is not yet a consistent risk factor for IHD. Low cholesterol in suicide patients (usually severely depressed) can be predicted by a severe decline in appetite and cease of food ingestion. Therefore, cholesterol levels in their serum should be decreased.
Treatment with TCAs results in improvement in depression symptoms, including appetite, but has bad side effects on heart. Hence, the diagnosed depressed patients, who already under treatment, have a higher risk of IHD than control. In those groups of depressed patients, serum cholesterol will be normal or higher than the baseline, but they have a higher risk of IHD.