Clinical Practice Guideline

Post Myocardial Infarction Depression

Detection and Treatment of Post-Myocardial Infarction

(Developed by the AAFP, September 2007)
(Reaffirmed, December 2014)

The guideline, Detection and Treatment of Post-Myocardial Infarction Depression, was developed by the American Academy of Family Physicians and approved by the Board of Directors in September 2007. The guideline was published in the Annals of Family Medicine on January 1, 2009.

Key Recommendations

  • Patients having a myocardial infarction should be screened for depression using a standardized depression symptom checklist at regular intervals during the post-myocardial infarction (post-MI) period, including during hospitalization.
  • Post-MI patients with a diagnosis of depression should be treated to improve their depression symptoms, with systems in place to ensure regular follow-up and monitoring of their treatment response and adherence to treatment.
  • Selective serotonin reuptake inhibitors (SSRIs) are preferred to trycyclic antidepressants for treatment of depression in post-MI patients.
  • Psychotherapy may be beneficial for treatment of depression in post-MI patients. The existing evidence does not establish what form of psychotherapy is preferred.

See the full recommendation for further details.

These guidelines are provided only as assistance for physicians making clinical decisions regarding the care of their patients. As such, they cannot substitute the individual judgment brought to each clinical situation by the patient’s family physician. As with all clinical reference resources, they reflect the best understanding of the science of medicine at the time of publication, but they should be used with the clear understanding that continued research may result in new knowledge and recommendations. These guidelines are only one element in the complex process of improving the health of America. To be effective, the guidelines must be implemented.