Selective serotonin reuptake inhibitors and endothelial function in women

Liisa Hantsoo, Kathryn A. Czarkowski, Josiah Child, Christopher Howes, C. Neill Epperson

Research output: Contribution to journalArticle

Abstract

Background: Among women worldwide, major depression (MDD) and heart disease rank first and second, respectively, in burden of disease. Although selective serotonin reuptake inhibitors (SSRIs) are frequently prescribed, possible inhibition of nitric oxide (NO) function has caused concerns about their effects on protective vascular mechanisms. Our study aimed to determine the effect of SSRIs on flow-mediated vascular dilatation (FMD), platelet aggregation, and platelet NO production among women. Methods: Women (n=28) without known cardiovascular disease were recruited prior to undergoing SSRI treatment for MDD, postpartum depression (PPD), or premenstrual dysphoric disorder (PMDD). Symptoms were quantified using the Hamilton Depression/Anxiety and Beck Depression scales. FMD, platelet aggregation, and platelet NO production were measured before and after 1 month of SSRI (sertraline, fluoxetine, or paroxetine) therapy. Results: Depression and anxiety symptoms decreased significantly with SSRI treatment (ps <0.01). FMD and platelet aggregation did not differ between pre-and posttreatment, although FMD rose to the normal range (≥8%) in two of three women with abnormal FMD prior to SSRI treatment. We observed a 21% decrease (p=0.024) in platelet NO production. Conclusions: SSRI treatment had little effect on FMD or platelet aggregation. The health impact of decreased NO production is unclear, particularly in this relatively young group of women without cardiovascular disease, but should be considered in future studies focusing on SSRI safety in patients with cardiovascular disease.

Original languageEnglish (US)
Pages (from-to)613-618
Number of pages6
JournalJournal of Women's Health
Volume23
Issue number7
DOIs
StatePublished - Jul 1 2014
Externally publishedYes

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Serotonin Uptake Inhibitors
Blood Vessels
Dilatation
Nitric Oxide
Platelet Aggregation
Depression
Cardiovascular Diseases
Blood Platelets
Anxiety
Therapeutics
Sertraline
Postpartum Depression
Paroxetine
Fluoxetine
Patient Safety
Heart Diseases
Reference Values
Health

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Selective serotonin reuptake inhibitors and endothelial function in women. / Hantsoo, Liisa; Czarkowski, Kathryn A.; Child, Josiah; Howes, Christopher; Epperson, C. Neill.

In: Journal of Women's Health, Vol. 23, No. 7, 01.07.2014, p. 613-618.

Research output: Contribution to journalArticle

Hantsoo, Liisa ; Czarkowski, Kathryn A. ; Child, Josiah ; Howes, Christopher ; Epperson, C. Neill. / Selective serotonin reuptake inhibitors and endothelial function in women. In: Journal of Women's Health. 2014 ; Vol. 23, No. 7. pp. 613-618.
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