OBJECTIVES: Anxiety and depression are prevalent in individuals with coronary heart disease. Selective-serotonin reuptake inhibitors (SSRI) are first-line therapy for many anxiety and depression disorders. Platelet aggregation inhibitors (PAI) are the cornerstone of therapy for various types of heart disease. These medications are relatively contraindicated due to an increased risk for many types of bleeding. The purpose of the study was to examine the prevalence and predictors of use of both SSRI and PAI among individuals with co-occurring heart disease and anxiety or depression. METHODS: Respondents who were age 22 years and older, alive throughout the study period, diagnosed with heart disease and co-occurring anxiety or depression (n= 1,253) in 2009-11 of the Medical Expenditures Panel Survey were included. Use of treatment was grouped as: 1) SSRI and PAI, 2) SSRI or PAI, and 3) Neither SSRI or PAI. RESULTS: Overall, 11.2% used both SSRI and PAI, 46.3% used SSRI or PAI, and 42.5% used neither SSRI nor PAI. Significant subgroup differences were observed in the use of treatment. Females were less likely to be prescribed the inappropriate combination [AOR 0.57 (95%CI= 0.36-0.92)] while respondents having education less than high school [AOR 2.27 (95%CI= 1.30-3.99)] or a diagnosis of diabetes [AOR 2.13 (95%CI= 1.28-3.53)] were more likely to be prescribed the inappropriate combination. CONCLUSIONS: In this sample potentially inappropriate medication use was prevalent. Patients with less education or lower socioeconomic status are more likely to have health disparities and are at higher risk for both physical and mental health conditions. In this study, the patients with lower levels of education were more likely to be receiving an inappropriate combination of medications. The strong association with diabetes diagnosis and treatment choice is important because of the increased risk for bleeding in patients who received treatment for diabetes.