Effects of Escitalopram on Anxiety in Patients with Acute Coronary Syndrome: A Randomized Controlled Trial
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective: There are no evidence-based practices for treating anxiety in patients with acute coronary syndrome (ACS). Thus, we investigated the effects of escitalopram on anxiety in this population. Methods: We enrolled 217 patients with ACS who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for depressive disorders into a randomized double-blind placebo-controlled study. Patients received either escitalopram or placebo over a 24-week period. Anxiety symptoms were evaluated using the Hospital Anxiety and Depression Scale-anxiety subscale (HADS-A). A HADS-A score ＞7 was classified as an anxiety disorder. Baseline evaluations included sociodemographic and clinical characteristics, such as depressive symptoms, cardiovascular risk factors, and current cardiac status. Results: Independent of improvements in depression and without any differences in safety profiles, escitalopram treatment was significantly more efficacious in treating and reducing anxiety than placebo over a 24-week period. Conclusion: Escitalopram can be recommended as an effective and safe treatment option for anxiety in patients with ACS.
Abstract
Objective: There are no evidence-based practices for treating anxiety in patients with acute coronary syndrome (ACS). Thus, we investigated the effects of escitalopram on anxiety in this population. Methods: We enrolled 217 patients with ACS who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for depressive disorders into a randomized double-blind placebo-controlled study. Patients received either escitalopram or placebo over a 24-week period. Anxiety symptoms were evaluated using the Hospital Anxiety and Depression Scale-anxiety subscale (HADS-A). A HADS-A score ＞7 was classified as an anxiety disorder. Baseline evaluations included sociodemographic and clinical characteristics, such as depressive symptoms, cardiovascular risk factors, and current cardiac status. Results: Independent of improvements in depression and without any differences in safety profiles, escitalopram treatment was significantly more efficacious in treating and reducing anxiety than placebo over a 24-week period. Conclusion: Escitalopram can be recommended as an effective and safe treatment option for anxiety in patients with ACS.
참고문헌 (18)
- Lichtman JH, "Depression as a risk factor for poor prognosis among patients with acute coronary syndrome : systematic review and recommendations : a scientific statement from the American Heart Association", Circulation, 129, pp.1350~1369 (2014)
- Meijer A, "Prognostic association of depression following myocardial infarction with mortality and cardiovascular events : a meta-analysis of 25 years of research", Gen Hosp Psychiatry, 33, pp.203~216 (2011)
- Kessler RC, "Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication", Arch Gen Psychiatry, 62, pp.617~627 (2005)
- Fava M, "Difference in treatment outcome in outpatients with anxious versus nonanxious depression : a STAR*D report", Am J Psychiatry, 165, pp.342~351 (2008)
- Lichtman JH, "Depression and coronary heart disease: recommendations for screening, referral, and treatment: a science advisory from the American Heart Association Prevention Committee of the Council on cardiovascular nursing, council on clinical cardiology, council on epidemiology and prevention, and interdisciplinary council on quality of care and outcomes research: endorsed by the American Psychiatric Association", Circulation, 118, pp.1768~1775 (2008)
- Cepeda-Valery B, "Measuring health related quality of life in coronary heart disease : the importance of feeling well", Int J Cardiol, 149, pp.4~9 (2011)
- Tully PJ, "The anxious heart in whose mind? A systematic review and meta-regression of factors associated with anxiety disorder diagnosis, treatment and morbidity risk in coronary heart disease", J Psychosom Res, 77, pp.439~448 (2014)
- Kim JM, "Escitalopram treatment for depressive disorder following acute coronary syndrome: a 24-week double-blind, placebocontrolled trial", J Clin Psychiatry, 76, pp.62~68 (2015)
- Thaler KJ, "Comparative effectiveness of secondgeneration antidepressants for accompanying anxiety, insomnia, and pain in depressed patients: a systematic review", Depress Anxiety, 29, pp.495~505 (2012)
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV)" (1994), American Psychiatric Press Inc
- Zigmond AS, "The hospital anxiety and depression scale", Acta Psychiatr Scand, 67, pp.361~370 (1983)
- Bjelland I, "The validity of the Hospital Anxiety and Depression Scale. An updated literature review", J Psychosom Res, 52, pp.69~77 (2002)
- Montgomery SA, "A new depression scale designed to be sensitive to change", Br J Psychiatry, 134, pp.382~389 (1979)
- Killip T 3rd, "Treatment of myocardial infarction in a coronary care unit. A two year experience with 250patients", Am J Cardiol, 20, pp.457~464 (1967)
- Kwan-Woo Choi, "Long-term Escitalopram Treatment in Korean Patients with Panic Disorder: A Prospective, Naturalistic, Open-label, Multicenter Trial", Clinical Psychopharmacology and Neuroscience, 10(1), pp.44~48 (2012), 대한정신약물학회
- Pae CU, "Antidepressant and QT interval prolongation, how should we look at this issue? Focus on citalopram", Expert Opin Drug Saf, 13, pp.197~205 (2014)
- Wang SM, "How much to worry about the FDA warning in the use of citalopram?", Expert Rev Neurother, 13, pp.883~886 (2013)
- Lespérance F, "Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease : the Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy(CREATE)trial", JAMA, 297, pp.367~379 (2007)