Escitalopram Treatment for Depressive Disorder Following Acute Coronary Syndrome: A 24-Week Double-Blind, Placebo-Controlled Trial
Abstract
Objective Depression is common after acute coronary syndrome (ACS) and has adverse effects on prognosis. There are few evidence-based interventions for treating depression in ACS. This study investigated the efficacy and safety of escitalopram in treating depressive disorders identified 2-14 weeks after a confirmed ACS episode. Method A total of 217 patients with DSM-IV depressive disorders (121 major and 96 minor) and ACS were randomly assigned to receive escitalopram in flexible doses of 5-20 mg/d (n = 108) or placebo (n = 109) for 24 weeks. The study was conducted from 2007 to 2013. The primary outcome measure was the Hamilton Depression Rating Scale (HDRS). Secondary outcome measures included the Montgomery-Asberg Depression Rating Scale (MADRS), Beck Depression Inventory (BDI), Clinical Global Impressions-Severity of Illness scale (CGI-S), Social and Occupational Functioning Assessment Scale (SOFAS), and World Health Organization Disability Assessment Schedule-12. Cardiovascular safety outcomes included echocardiography, electrocardiography, laboratory test, body weight, and blood pressure results. Results Escitalopram was superior to placebo in reducing HDRS scores (mean difference = 2.3, P = .016, effect size = 0.38). Escitalopram was also superior to placebo in decreasing depressive symptoms evaluated by the MADRS, BDI, and CGI-S and in improving SOFAS functioning level. Escitalopram was not associated with any harmful changes in cardiovascular safety measures. Dizzin…
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Initial placebo-controlled studies of standard antidepressants (primarily SSRIs) found that these agents were safe and largely effective in the prevention or treatment of major depressive disorder among patients with cardiovascular disease.
“Initial placebo-controlled studies of standard antidepressants (primarily SSRIs) found that these agents were safe and largely effective in the prevention or treatment of major depressive disorder among patients with CVD, 173-177”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [175]
Those initial placebo-controlled antidepressant studies were not powered or designed to detect effects on cardiac risk factors, health behaviors, or cardiac events.
“but these studies were not powered or designed to detect effects on cardiac risk factors, health behaviors, or cardiac events.”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [175]
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Cited by 71
- Authors
- Kim, J.-M., Bae, K.-Y., Stewart, R., Jung, B.-O., Kang, H.-J., Kim, S.-W., Shin, I.-S., Hong, Y. J., Kim, J. H., Shin, H.-Y., Kang, G., Ahn, Y., Kim, J.-K., Jeong, M. H., & Yoon, J.-S.
- Affiliations
- Chonnam National University (KR)
- ORCID
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2014-10-14
- Volume
- 76
- Issue
- 01
- Pages
- 62-68
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2035697132
- Cited by
- 71
- References
- 0
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 4 · 2021: 7 · 2020: 6 · 2019: 9 · 2018: 9 · 2017: 10 · 2016: 8 · 2015: 8
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- escitalopram, depression, acute coronary syndrome, antidepressant efficacy, cardiovascular safety, major depressive disorder, minor depressive disorder, dizziness, functional recovery
- MeSH terms
- Aged, Depressive Disorder, Double-Blind Method, Female, Humans, Male, Middle Aged, Placebos, Citalopram, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Acute Coronary Syndrome
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