Effects of heart disease on depression treatment: Results from the COMED study

Kevin Brian Kerber, Stephen R. Wisniewski, James F. Luther, Andrew F. Leuchter, Inna D'Empaire, Madhukar H. Trivedi, A. John Rush

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objective: To determine the impact of self-reported heart disease (HD) on major depressive disorder (MDD) treatment outcomes. Method: This single-blind, 7-month prospective randomized trial enrolled 665 participants, 18-75 years old, from six primary and nine psychiatric care sites across the USA. Participants had at least moderately severe (baseline 17-item Hamilton Rating Scale of Depression ≥16), nonpsychotic chronic and/or recurrent MDD. Participants with and without self-reported HD were randomized into three treatment groups (1:1:1 ratio): escitalopram plus placebo, bupropion sustained-release plus escitalopram or venlafaxine extended-release plus mirtazapine. The primary outcome (remission) was defined by the last two consecutive 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR 16) ratings: one had to be <8 and one <6. Secondary outcomes included response (reduction in QIDS-SR 16 >50%) side-effect burden, quality of life and functioning. A P value <.05 indicated statistical significance. Result: Participants with HD were less depressed at baseline and demonstrated fewer side effects at Treatment Weeks 12 and 28. The HD groups did not differ regarding remission [40.0% (16/40) vs. 38.2% (239/625),. P=.5566] or response [50% (20/40) vs. 52.1% (314/625),. P=.8055]. Conclusions: Despite apparent baseline and side-effect differences between participants with and without HD, the two groups did not differ regarding MDD treatment outcomes.

Original languageEnglish (US)
Pages (from-to)24-34
Number of pages11
JournalGeneral Hospital Psychiatry
Volume34
Issue number1
DOIs
StatePublished - Jan 1 2012

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Keywords

  • CO-MED study
  • Depression treatment
  • Heart disease

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Kerber, K. B., Wisniewski, S. R., Luther, J. F., Leuchter, A. F., D'Empaire, I., Trivedi, M. H., & Rush, A. J. (2012). Effects of heart disease on depression treatment: Results from the COMED study. General Hospital Psychiatry, 34(1), 24-34. https://doi.org/10.1016/j.genhosppsych.2011.08.018