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Chávez-Castillo et al. Vessel Plus 2018;2:6 I http://dx.doi.org/10.20517/2574-1209.2018.02 Page 7 of 11

disorders, bipolar disorder and schizophrenia [58,90,93,99] . At most, specific SSRIs such as sertraline and
paroxetine may be linked to hypertension in < 1% of cases, while fluoxetine and citalopram appear to be
innocuous in this regard .
[94]
On the contrary, SSRIs may have a beneficial effect on blood pressure, especially by diminishing mean or
systolic blood pressure, presumably via an inhibitory effect on the autonomic nervous system . Notably, a
[100]
report by Serodio et al. found that, at any body mass index, systolic blood pressure was significantly lower
[85]
in subjects treated with SSRIs than in those without antidepressant treatment, although this corresponded
to a small 4 mmHg difference. In summary, although scarce, currently available evidence suggests no
relationship between SSRIs and hypertension, and this might not be one of the principal contributions of
these drugs in the development of MS.

CONCLUSIONS
At present, enough evidence is available to affirm SSRIs intervene in the pathogenesis of certain components
of MS. However, this impact is not equal for all SSRIs; rather, each drug in this groups has shown a particular
cardiometabolic profile, differentially affecting body weight and composition, serum lipids, glycemia,
blood pressure, and other parameters. These findings highlight the importance of holistic, patient-centered
prescribing as a fundamental principle in clinical psychopharmacology. Further research is required to
determine optimal approaches for the management of the metabolic effects of SSRIs. Future developments
in psychopharmacology should consider the metabolic safety of novel drugs, in view of the burden CVD
implies for public health, and the close association between mental and cardiometabolic disorders.

DECLARATIONS
Authors’ contributions
Manuscript writing and editing, workgroup supervision, academic and methodological advisory: Chávez-
Castillo M, Velasco M, Bermúdez V, Rojas-Quintero J
Data gathering and manuscript writing: Ortega Á, Nava M, Fuenmayor J, Lameda V

Financial support and sponsorship
This work was supported by Research Grant no. CC-0437-10-21-09-10 from the Technological, Humanistic,
and Scientific Development Council (CONDES), University of Zulia, and Research Grant no. FZ-0058-2007
from Fundacite Zulia.

Conflicts of interest
There are no conflicts of interest.

Patient consent
Not applicable.

Ethics approval
Not applicable.

Copyright
© The Author(s) 2018.

REFERENCES
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