Depressive disorder and cardiovascular diseases have common pathophysiological mechanisms. They include both biological and behavioral mechanisms. The principal biological mechanisms are: the activation of hypothalamo-pitutio-adrenal axis with increased activation of sympathetic nervous system, decreased vagal tonus followed by decreased heart rate variability and the changes in thrombogenesis with increased thrombocytic agregability. These three mechanisms are followed by the cascade of other processes, which are interconnected with each other, they are mutually inseparable and cause the damage of cardiovascular system. These fi ndings are important for clinical praxis. Patients who suffer nontreated depressive disorder have a higher risk of development of cardiovascular diseases than the depressive patients treated with antidepressants including the tricyclic ones, which have the potential risk of cardiotoxicity. Hopeful is using the SSRI antidepressants, which have the benign cardiovascular profi le. The conclusion includes the necessity to establish the diagnosis of the depressive disorder and than to treat it to prevent the patient’s suicide and also to decrease the risk of development of the cardiovascular diseases.

        Key words: depressive disorder, cardiovascular diseases, pathophysiological mechanisms, cardiotoxicity