open access

Vol 9, No 2 (2012)
Review paper
Published online: 2012-09-05
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Psychological consequences of acute myocardial infarction. Psychotropic drugs in patients after acute myocardial infarction

Bożena Szyguła-Jurkiewicz, Monika Szymik, Barbara Mrozowska, Barbara Schmidt, Alicja Michalak
Psychiatria 2012;9(2):60-67.

open access

Vol 9, No 2 (2012)
Prace poglądowe - nadesłane
Published online: 2012-09-05

Abstract

The patients with acute myocardial infarction have many emotional and behavioral problems and some of them may also have psychopatological problems. The psychosocial factors with proven impact on the prognosis in somatic diseases are chronic stress factors (eg lack of social support or low economic status) and emotional factors (depression, anxiety disorders, personality traits). In patients with myocardial infarction it is essential to use antianxiety agents because the occuring feeling of anxiety causes a discomfort and leads to sympathetic nervous system stimulation which negatively influences the course of the disease. Benzodiazepines are the drugs of choice in the anti-anxiety treatment. The confusional state and the cognitive disorders may occur in patients after cardiac arrest and in the eldelry. It may lead to brain hypoperfusion or hypoxia, dehydration or overhydration, electrolyte disorders, liver or kidney failure, endocrine disorders, or infection. A frequent cause of these states is the sudden withdrawal of alcohol or drugs, therefore it is always important to take the history which includes that factors. In the therapy of delirium and the cognitive disorders the use of haloperidol, benzodiazepines with short half-life (eg lorazepam) or atypical antipsychotics are both safe and effective. 40–65% of patients after myocardial infarction are presented with clinically significant depressive symptoms and 25% with severe depression. Selective serotonin reuptake inhibitors and cognitive-behavioural therapy are recommended in the treatment of depression. It is essential to choose carefully the psychotropic drugs in patients with myocardial infarction. There are possible interactions between active substances in multidrug therapy. Good understanding of the pharmacodynamic properties of medications allows to use positive interactions and avoid negative ones.

Abstract

The patients with acute myocardial infarction have many emotional and behavioral problems and some of them may also have psychopatological problems. The psychosocial factors with proven impact on the prognosis in somatic diseases are chronic stress factors (eg lack of social support or low economic status) and emotional factors (depression, anxiety disorders, personality traits). In patients with myocardial infarction it is essential to use antianxiety agents because the occuring feeling of anxiety causes a discomfort and leads to sympathetic nervous system stimulation which negatively influences the course of the disease. Benzodiazepines are the drugs of choice in the anti-anxiety treatment. The confusional state and the cognitive disorders may occur in patients after cardiac arrest and in the eldelry. It may lead to brain hypoperfusion or hypoxia, dehydration or overhydration, electrolyte disorders, liver or kidney failure, endocrine disorders, or infection. A frequent cause of these states is the sudden withdrawal of alcohol or drugs, therefore it is always important to take the history which includes that factors. In the therapy of delirium and the cognitive disorders the use of haloperidol, benzodiazepines with short half-life (eg lorazepam) or atypical antipsychotics are both safe and effective. 40–65% of patients after myocardial infarction are presented with clinically significant depressive symptoms and 25% with severe depression. Selective serotonin reuptake inhibitors and cognitive-behavioural therapy are recommended in the treatment of depression. It is essential to choose carefully the psychotropic drugs in patients with myocardial infarction. There are possible interactions between active substances in multidrug therapy. Good understanding of the pharmacodynamic properties of medications allows to use positive interactions and avoid negative ones.
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Keywords

myocardial infarction; stress; depression; anxiety; cognitive disorders; psychotropic drugs; personality traits

About this article
Title

Psychological consequences of acute myocardial infarction. Psychotropic drugs in patients after acute myocardial infarction

Journal

Psychiatria (Psychiatry)

Issue

Vol 9, No 2 (2012)

Article type

Review paper

Pages

60-67

Published online

2012-09-05

Bibliographic record

Psychiatria 2012;9(2):60-67.

Keywords

myocardial infarction
stress
depression
anxiety
cognitive disorders
psychotropic drugs
personality traits

Authors

Bożena Szyguła-Jurkiewicz
Monika Szymik
Barbara Mrozowska
Barbara Schmidt
Alicja Michalak

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