A 45-year-old man is started on sertraline after a myocardial infarction for moderate depression. Why is this a reasonable choice?
Answer and explanation
Correct answer: A. It has the best evidence for safety after recent cardiac disease
- Step 1: Antidepressant choice in cardiac disease must take cardiotoxicity into account. Step 2. Sertraline is the SSRI with the strongest safety data after myocardial infarction. Answer: It has the best evidence for safety after recent cardiac disease. Why not the others: Tricyclics are dangerous in the post-infarct heart. Sertraline is not a rate-lowering drug. SSRIs are used after MI.
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