Bibliographical noteFunding Information:
We appreciate the interest in our article 1 and the comment of Pizzi et al highlighting that some types of antidepressants may have harmful effects in patients with coronary heart disease. The participants in the SWAN as well as in the substudy SWAN Heart were middle-aged women undergoing the menopausal transition. Because rates of cardiovascular disease (CVD) increase for women in this age group, it is important to find ways to reduce their CVD burden. In this healthy population, we found that depressive symptoms were significantly positively related to progression of coronary artery calcification (CAC), an early marker of CVD, especially heart disease. In a recent review article, statins have been shown to be not effective in lowering CAC scores 2 ; therefore, it seems prudent to look for other measures that might benefit women. We had too few women treated with antidepressants to draw any conclusions as to the effects of antidepressant medication on CAC progression so that the issue remains an open research question. Because of the small number, we could not look at subgroups of different types of antidepressant medications. We agree with Pizzi et al that a clinical trial remains to be conducted to evaluate the effects of antidepressants, especially selective seratonin reuptake inhibitors in women with any CAC. The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH, DHHS), through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women’s Health (ORWH) (Grants NR004061; AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, AG012495). The content of this letter is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH or the NIH.