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Depression Medication Effective in Cardiac Patients
Written by Jeanne Bohm, Ph.D.   

Patients with coronary artery disease and symptoms of depression showed improvement in their depression symptoms with citalopram, but no additional improvement was found with interpersonal psychotherapy, according to a study in the January 24/31 issue of JAMA.

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Since the early 1990s, studies have reported a prevalence between 17 and 27 percent of major depression in hospitalized patients with coronary artery disease (CAD).

Francois Lespérance, M.D., of the Université de Montréal, and colleagues with the Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) trial, evaluated the short-term effectiveness and tolerability of two depression treatments in CAD patients: citalopram, a selective serotonin reuptake inhibitor (SSRI) antidepressant and interpersonal psychotherapy (IPT), a short-term, manual-based psychotherapy focusing on the social context of depression. The 12-week study included 284 patients with CAD (May 2002 to March 2006). All patients met criteria for a diagnosis of major depression of four weeks’ duration or longer.

Participants were randomized: (1) to receive either 12 weekly sessions of IPT plus clinical management (n = 142) or clinical management only (n = 142) and (2) to receive either 12 weeks of citalopram (n = 142), or matching placebo (n = 142).

Clinical management involved weekly sessions with information about depression and medication use. IPT involved sessions dealing with problems common in patients with CAD.

The researchers found that citalopram was effective in reducing depressive symptoms as well as remission and response rates and average changes on a depression measurement scale. Although patients improved with both IPT and clinical management, and remission and response rates did not differ between those two treatments.

The authors add that the benefits of citalopram was also evident in changes in perceived social support and daily function.

Authors concluded that Citalopram (or sertraline) and clinical management should be considered for the initial acute-phase treatment for major depression in CAD patients.


JAMA News Release

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. 2007;297:367-379. 

About the Author

Jeanne Bohm, Ph.D. is a cancer biologist by training, a medical writer and an experienced science educator.

The author has no financial relationship to any of the companies listed in the article.

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