TY - JOUR
T1 - Effects of heart disease on depression treatment
T2 - Results from the COMED study
AU - Kerber, Kevin Brian
AU - Wisniewski, Stephen R.
AU - Luther, James F.
AU - Leuchter, Andrew F.
AU - D'Empaire, Inna
AU - Trivedi, Madhukar H.
AU - Rush, A. John
PY - 2012/1
Y1 - 2012/1
N2 - 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.
AB - 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.
KW - CO-MED study
KW - Depression treatment
KW - Heart disease
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U2 - 10.1016/j.genhosppsych.2011.08.018
DO - 10.1016/j.genhosppsych.2011.08.018
M3 - Article
C2 - 22001552
AN - SCOPUS:84855345949
SN - 0163-8343
VL - 34
SP - 24
EP - 34
JO - General Hospital Psychiatry
JF - General Hospital Psychiatry
IS - 1
ER -