Common antidepressant could be used to treat debilitating heart condition

A popular antidepressant could be used to treat a chronic heart condition. See if you’re eligible for the world-first Melbourne trial.

Atrial Fibrillation symptoms include chest pain, fatigue and shortness of breath. Picture: iStock

One of the most popular types of antidepressants could also treat a debilitating heart condition, with a world-first local trial set to put the theory to the test.

Royal Melbourne Hospital researchers will track the impact of a common depression drug on symptoms of Atrial Fibrillation, a chronic cardiac condition that can lead to strokes and blood clots in serious cases.

They hope Lexapro and other selective serotonin reuptake inhibitors (SSRIs) could help AF patients who don’t respond well to current treatment and reduce the need for a surgical procedure.

Study co-ordinator RMH electrophysiology fellow Dr Youlin Koh said the SAD-AF trial had the “potential” to “revolutionise the management of AF”.

“There’s a lot of current treatments out there but some have limiting side effects like thyroid problems or causing heart rates to go down too low,” she said.

She said it was the tendency for AF and depression to “happen together quite frequently” — and similarities between the two conditions — that led to them investigating SSRIs.

Researchers will track the effect of common antidepressant drug Lexapro on symptoms of Atrial Fibrillation.

“In both conditions, the fight or flight nervous system – also called the autonomic nervous system, is dysregulated,” she said.

She said they hoped to show a link between antidepressants “improving the fight or flight system and, by virtue of that, improving the AF”.

“Some of the tissues in the heart have receptors … that are a target of this medication,” she said.

“There’s some other studies that showed serotonin-based antidepressants seem to improve markers of this nervous system function, so we thought it was probably worth studying in Atrial Fibrillation.”

She said AF occurred when the “two top chambers of the heart are not co-ordinated and pump very quickly”.

“It’s very irregular and in the worst case, this can lead to serious consequences like blood clots and stroke or … heart failure,” she said.

“More commonly, people just get a lot of symptoms from having their heart going so fast all the time.”

She said these included fatigue, chest pain, shortness of breath and could have a significant impact on a patient’s quality of life.

Dr Koh said, in addition to targeting the “mechanistic, physical” side of AF, the SSRIs could also improve patients’ heart disorder by treating their depressive symptoms and therefore making it easier for them to live a healthy lifestyle.

Dr Koh’s PhD supervisor Melbourne University’s Michael Wong said Australian researchers were the first to show lifestyle factors — such as weight and drinking — impacted AF.

“This (psychosocial factors) is the next unanswered question,” Associate Professor Wong said.

Dr Koh said repurposing an existing drug, which has already passed rigorous safety tests, “takes away a significant amount of time that’s involved in developing a new medication”.

Recruitment is now under way at RMH, with the Alfred and Western Health to follow, for up to 150 patients with intermittent or treated AF and depressive symptoms.

For details on the trial, email [e-mail]