Celexa relieves depression in heart patients

NEW YORK (Reuters Health) - The antidepressant Celexa, known generically as citalopram, improves symptoms of major depression in people with coronary artery disease (CAD), according to a Canadian study.

Writing in this week's Journal of the American Medical Association, psychiatrist Dr. Francois Lesperance, at the University of Montreal, and his associates note that CAD patients are prone to develop major depression, but not much research has been done on treatments for depression in these patients.

The team therefore conducted a 12-week trial involving 284 people with stable CAD who had major depression for at least 4 weeks.

Half the patients were randomly assigned to take citalopram, one of the newer SSRI antidepressants, or an inactive placebo pill, while the other half were assigned to clinical management, with or without psychotherapy.

Clinical management included doctor visits to discuss depression and medication use, provide reassurance, and inquire about patients' symptoms. Psychotherapy took place immediately after the clinical management sessions, and dealt with problems such as interpersonal conflicts, life transitions, grief and loss, and social isolation.

Citalopram was superior to placebo in reducing depressive symptoms. Standardized depression scores were 67 percent more likely to drop by half on citalopram than placebo, and the chance of depression remitting was almost doubled.

In contrast, interpersonal psychotherapy appeared to have no effect on symptoms of depression.

In an editorial, Drs. Alexander H. Glassman and J. Thomas Bigger, Jr., both at Columbia University College of Physicians and Surgeons in New York, advise doctors to "screen for depression in patients with coronary heart disease and maintain a low threshold for treatment with an SSRI."

SOURCE: Journal of the American Medical Association, January 24/31, 2007.