Depression is common in older adults and those with cardiovascular disease. Although selective serotonin reuptake inhibitors generally have been shown to be safe to treat depression in these patients, it is important to identify additional antidepressants when selective serotonin reuptake inhibitors are not effective. This qualitative narrative review summarizes what is known about the cardiovascular side effects of some of the newer antidepressants. Twelve novel non-selective serotonin reuptake inhibitor antidepressants were identified from the literature: venlafaxine, desvenlafaxine, duloxetine, milnacipran, levomilnacipran, mirtazapine, bupropion, vilazodone, vortioxetine, agomelatine, moclobemide, and ketamine–esketamine. A search restricted to publications written in English was conducted in PubMed and Google Scholar with the following search criteria: the specific antidepressant AND (QT OR QTc OR “heart rate” OR “heart rate variability” OR “hypertension” OR “orthostatic hypotension” OR “cardiovascular outcomes” OR “arrhythmia” OR “myocardial infarction” OR “cardiovascular mortality”) AND (geriatric OR “older adults” OR “late life depression” OR “cardiovascular disease” OR “hospitalized” OR “hospitalized”). The recommended use, dosing ranges, cardiovascular effects, and general advantages and disadvantages of each of the drugs are discussed. Levomilnacipran and vilazodone have not received enough study to judge their safety in older patients or in those with, or at high risk for, cardiovascular disease. There is at least some evidence for possible adverse events with each of the other newer antidepressants that could be of concern in these patients. Nevertheless, with careful administration and attention to the potential adverse reactions for each drug, these may provide safe effective alternatives for older adults and patients with cardiovascular disease who do not respond to selective serotonin reuptake inhibitor antidepressants. However, more research on the safety and efficacy of these drugs in these specific patient populations is urgently needed.

抑郁症在老年人和心血管疾病患者中很常见。Although selective serotonin reuptake inhibitors generally have been shown to be safe to treat depression in these patients, it is important to identify additional antidepressants when selective serotonin reuptake inhibitors are not effective. 这篇定性叙述性综述总结了一些新型抗抑郁药的心血管副作用。从文献中鉴定出 12 种新型非选择性 5-羟色胺再摄取抑制剂抗抑郁药：文拉法辛、去甲文拉法辛、度洛西汀、米那普仑、左旋米那普仑、米氮平、安非他酮、维拉佐酮、沃替西汀、阿戈美拉汀、吗氯胺酮和氯胺酮。使用以下搜索标准在 PubMed 和 Google Scholar 中进行了仅限于英文出版物的搜索：特定的抗抑郁药 AND（QT 或 QTc 或“心率”或“心率变异性”或“高血压”或“直立性低血压”或“心血管结果”或“心律失常”或“心肌梗塞”或“心血管死亡率”）和（老年或“老年人”或“晚年抑郁症”或“心血管疾病”或“住院”或“住院”）。讨论了每种药物的推荐用途、剂量范围、心血管作用和一般优缺点。左旋米那普仑和维拉佐酮尚未接受足够的研究来判断它们在老年患者或患有心血管疾病或高危心血管疾病的患者中的安全性。至少有一些证据表明，这些患者可能会担心其他每一种较新的抗抑郁药可能出现的不良事件。尽管如此，通过谨慎给药并注意每种药物的潜在不良反应，这些可能为老年人和心血管疾病患者提供安全有效的替代方案，这些患者对选择性血清素再摄取抑制剂抗抑郁药无反应。然而，迫切需要对这些药物在这些特定患者人群中的安全性和有效性进行更多研究。这些可能为老年人和心血管疾病患者提供安全有效的替代品，这些患者对选择性血清素再摄取抑制剂抗抑郁药没有反应。然而，迫切需要对这些药物在这些特定患者人群中的安全性和有效性进行更多研究。这些可能为老年人和心血管疾病患者提供安全有效的替代品，这些患者对选择性血清素再摄取抑制剂抗抑郁药没有反应。然而，迫切需要对这些药物在这些特定患者人群中的安全性和有效性进行更多研究。