Escitalopram for Severe Asthma and Major Depressive Disorder: A Randomized, Double-Blind, Placebo-Controlled Proof-of-Concept Study

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Depression is common in asthma and may be a risk factor for asthma-related morbidity and mortality. However, minimal data are available on depression treatment in asthma. Previously, we reported greater sustained depression remission and less oral corticosteroid use in asthma patients treated with citalopram. Method: A 12-week randomized, double-blind, placebo-controlled, proof-of-concept trial of escitalopram was conducted in 26 outpatients with asthma requiring at least one course of oral corticosteroids in the prior 12 months and major depressive disorder (MDD) with baseline Hamilton Rating Scale for Depression (HAM-D) scores of ≥ 20. Results: Total evaluable sample (n = 25) showed significant baseline to exit reduction in HAM-D and Inventory of Depressive Symptomatology-Self Report (IDS-SR) scores, with no significant between-group differences, although the findings favored escitalopram. Depression remission on the HAM-D, from week 1 to exit, showed a trend (P = 0.06) favoring escitalopram. Relative risk for remission at week 12 was 6.5 with an estimated remission rate of 39.1% with escitalopram and 6.0% with placebo. Between-group differences in oral corticosteroid use were not significant. Changes in Asthma Control Questionnaire (ACQ) correlated significantly with changes in IDS-SR in the escitalopram, placebo, and combined sample groups (τ = 0.49-0.60, P < 0.05) and with changes in HAM-D only in placebo and combined groups (τ = 0.38-0.58, P < 0.05). Conclusions: Medium effect sizes and a remission trend were observed favoring escitalopram over placebo on depression measures. Changes in self-reported depressive symptoms correlated with changes in asthma symptoms. A larger trial is needed to confirm the findings from this pilot study.

Original languageEnglish (US)
Pages (from-to)75-80
Number of pages6
JournalPsychosomatics
Volume53
Issue number1
DOIs
StatePublished - Jan 2012

Fingerprint

Citalopram
Major Depressive Disorder
Asthma
Placebos
Depression
Adrenal Cortex Hormones
Self Report
Equipment and Supplies
compound A 12
Placebo
Controlled
Outpatients
Remission
Morbidity
Mortality

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology
  • Arts and Humanities (miscellaneous)

Cite this

@article{21279dce0f5f4b10879dff89570f6636,
title = "Escitalopram for Severe Asthma and Major Depressive Disorder: A Randomized, Double-Blind, Placebo-Controlled Proof-of-Concept Study",
abstract = "Background: Depression is common in asthma and may be a risk factor for asthma-related morbidity and mortality. However, minimal data are available on depression treatment in asthma. Previously, we reported greater sustained depression remission and less oral corticosteroid use in asthma patients treated with citalopram. Method: A 12-week randomized, double-blind, placebo-controlled, proof-of-concept trial of escitalopram was conducted in 26 outpatients with asthma requiring at least one course of oral corticosteroids in the prior 12 months and major depressive disorder (MDD) with baseline Hamilton Rating Scale for Depression (HAM-D) scores of ≥ 20. Results: Total evaluable sample (n = 25) showed significant baseline to exit reduction in HAM-D and Inventory of Depressive Symptomatology-Self Report (IDS-SR) scores, with no significant between-group differences, although the findings favored escitalopram. Depression remission on the HAM-D, from week 1 to exit, showed a trend (P = 0.06) favoring escitalopram. Relative risk for remission at week 12 was 6.5 with an estimated remission rate of 39.1{\%} with escitalopram and 6.0{\%} with placebo. Between-group differences in oral corticosteroid use were not significant. Changes in Asthma Control Questionnaire (ACQ) correlated significantly with changes in IDS-SR in the escitalopram, placebo, and combined sample groups (τ = 0.49-0.60, P < 0.05) and with changes in HAM-D only in placebo and combined groups (τ = 0.38-0.58, P < 0.05). Conclusions: Medium effect sizes and a remission trend were observed favoring escitalopram over placebo on depression measures. Changes in self-reported depressive symptoms correlated with changes in asthma symptoms. A larger trial is needed to confirm the findings from this pilot study.",
author = "Brown, {E. Sherwood} and Christina Howard and Khan, {David A.} and Carmody, {Thomas J.}",
year = "2012",
month = "1",
doi = "10.1016/j.psym.2011.07.009",
language = "English (US)",
volume = "53",
pages = "75--80",
journal = "Psychosomatics",
issn = "0033-3182",
publisher = "American Psychiatric Publishing Inc.",
number = "1",

}

TY - JOUR

T1 - Escitalopram for Severe Asthma and Major Depressive Disorder

T2 - A Randomized, Double-Blind, Placebo-Controlled Proof-of-Concept Study

AU - Brown, E. Sherwood

AU - Howard, Christina

AU - Khan, David A.

AU - Carmody, Thomas J.

PY - 2012/1

Y1 - 2012/1

N2 - Background: Depression is common in asthma and may be a risk factor for asthma-related morbidity and mortality. However, minimal data are available on depression treatment in asthma. Previously, we reported greater sustained depression remission and less oral corticosteroid use in asthma patients treated with citalopram. Method: A 12-week randomized, double-blind, placebo-controlled, proof-of-concept trial of escitalopram was conducted in 26 outpatients with asthma requiring at least one course of oral corticosteroids in the prior 12 months and major depressive disorder (MDD) with baseline Hamilton Rating Scale for Depression (HAM-D) scores of ≥ 20. Results: Total evaluable sample (n = 25) showed significant baseline to exit reduction in HAM-D and Inventory of Depressive Symptomatology-Self Report (IDS-SR) scores, with no significant between-group differences, although the findings favored escitalopram. Depression remission on the HAM-D, from week 1 to exit, showed a trend (P = 0.06) favoring escitalopram. Relative risk for remission at week 12 was 6.5 with an estimated remission rate of 39.1% with escitalopram and 6.0% with placebo. Between-group differences in oral corticosteroid use were not significant. Changes in Asthma Control Questionnaire (ACQ) correlated significantly with changes in IDS-SR in the escitalopram, placebo, and combined sample groups (τ = 0.49-0.60, P < 0.05) and with changes in HAM-D only in placebo and combined groups (τ = 0.38-0.58, P < 0.05). Conclusions: Medium effect sizes and a remission trend were observed favoring escitalopram over placebo on depression measures. Changes in self-reported depressive symptoms correlated with changes in asthma symptoms. A larger trial is needed to confirm the findings from this pilot study.

AB - Background: Depression is common in asthma and may be a risk factor for asthma-related morbidity and mortality. However, minimal data are available on depression treatment in asthma. Previously, we reported greater sustained depression remission and less oral corticosteroid use in asthma patients treated with citalopram. Method: A 12-week randomized, double-blind, placebo-controlled, proof-of-concept trial of escitalopram was conducted in 26 outpatients with asthma requiring at least one course of oral corticosteroids in the prior 12 months and major depressive disorder (MDD) with baseline Hamilton Rating Scale for Depression (HAM-D) scores of ≥ 20. Results: Total evaluable sample (n = 25) showed significant baseline to exit reduction in HAM-D and Inventory of Depressive Symptomatology-Self Report (IDS-SR) scores, with no significant between-group differences, although the findings favored escitalopram. Depression remission on the HAM-D, from week 1 to exit, showed a trend (P = 0.06) favoring escitalopram. Relative risk for remission at week 12 was 6.5 with an estimated remission rate of 39.1% with escitalopram and 6.0% with placebo. Between-group differences in oral corticosteroid use were not significant. Changes in Asthma Control Questionnaire (ACQ) correlated significantly with changes in IDS-SR in the escitalopram, placebo, and combined sample groups (τ = 0.49-0.60, P < 0.05) and with changes in HAM-D only in placebo and combined groups (τ = 0.38-0.58, P < 0.05). Conclusions: Medium effect sizes and a remission trend were observed favoring escitalopram over placebo on depression measures. Changes in self-reported depressive symptoms correlated with changes in asthma symptoms. A larger trial is needed to confirm the findings from this pilot study.

UR - http://www.scopus.com/inward/record.url?scp=84859538754&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859538754&partnerID=8YFLogxK

U2 - 10.1016/j.psym.2011.07.009

DO - 10.1016/j.psym.2011.07.009

M3 - Article

C2 - 22221724

AN - SCOPUS:84859538754

VL - 53

SP - 75

EP - 80

JO - Psychosomatics

JF - Psychosomatics

SN - 0033-3182

IS - 1

ER -