Depression drug successful for heart patients

The Universite de Montreal evaluated the short-term effectiveness and tolerability of two depression treatments in patients with coronary artery disease (CAD); citalopram, a selective serotonin reuptake inhibitor (SSRI) antidepressant and interpersonal psychotherapy (IPT).

Participants were randomized to receive either 12 weekly sessions of IPT plus clinical management or clinical management only and to receive either 12 weeks of citalopram, or matching placebo.

Clinical management involved weekly sessions with information about depression and medication use, reassurance, and encouragement of adherence to medication and the study protocol. Interpersonal psychotherapy involved sessions dealing with problems common in patients with CAD, including interpersonal conflicts, life transitions, grief and loss.

The researchers found that citalopram was superior to placebo in reducing depressive symptoms in all efficacy measures. The remission and response rates and average changes on a depression measurement scale also consistently favored citalopram over placebo. The superiority of citalopram was apparent by 6 weeks. Although patients improved with both IPT and clinical management, there was no evidence of superiority for IPT, and remission and response rates did not differ between those two treatments.

The authors add that the benefits of citalopram extended to changes in perceived social support and daily function.

“Citalopram plus clinical management should be considered for the initial acute-phase treatment for major depression in patients with CAD. It remains to be demonstrated that any form of psychotherapy is superior to clinical management in reducing depression symptoms in this group,” the researchers concluded.