[Effects of antidepressant therapy in patients with suspected "angina pectoris" and negative coronary angiogram complicating comorbid depression].
OBJECTIVE
We observed the therapeutic effectiveness and safety of different antidepressants as well as the correlation between symptomatic improvement of depression and improvement of chest pain in patients with susceptible "angina pectoris" and negative coronary angiogram complicating comorbid depression.


METHODS
In this double-blinded randomized study, a total of 123 eligible patients were allocated into three groups: (1) Group F: fluoxetine 20 mg QN (n = 41); (2) Group P: Placebo 1 tablet QN (n = 40); (3) Group F + O: fluoxetine 20 mg + olanzapine 2.5 mg QN for the former 2 weeks and only fluoxetine 20 mg QN for the latter 2 weeks (n = 42). The total therapy duration was 4 weeks. HAMD, HAMA and self-evaluation table of chest pain were obtained before therapy, at the end of 1 and 2 weeks after therapy.


RESULTS
Baseline HAMD and HAMA scores and self-evaluation score of chest pain were similar among 3 groups and all scores were significantly improved post various therapies in the order of group F + O > group F > group P. The rate of score decrease were seen after 1 week treatment in group F + O and after 2 week treatment in group F. There was a significant positive correlation between the rates of self-evaluation chest pain score decrease and HAMD (r = 0.867, P < 0.001) and HAMA (r = 0.854, P < 0.001) score decreases after 4 weeks therapies (P < 0.05). During the whole course of treatment, no serious adverse reaction was found in all patients.


CONCLUSIONS
In patients with suspected "angina pectoris" and negative coronary angiogram complicating comorbid depression, the antidepressants were safe and significantly improved the symptoms of depression and anxiety and chest pain. Low dose fluoxetine plus short term olanzapine regimen was superior to fluoxetine alone regimen in terms of stronger and quicker symptom improvement.
Zheng
An-Lin
AL
Huadong Hospital, Shanghai 200040, China.
Qi
Wen-Hang
WH
Hu
Da-Yi
DY
Cai
Nai-Sheng
NS
Ge
Jun-Bo
JB
Fan
Wei-Hu
WH
Ni
You-Fang
YF
Lu
Guo-Ping
GP
Zhang
Feng-Ru
FR
Wei
Meng
M
He
Ben
B
Wu
Shi-Yao
SY
Sun
Bao-Gui
BG
Wu
Zong-Gui
ZG
Jin
Hui-Gen
HG
Huang
Yun
Y
D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000523:psychology*; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D017023:Coronary Angiography; D003866:Depressive Disorder / Q000188:drug therapy* / Q000209:etiology*; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine
D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine; D001569:Benzodiazepines; D000077152:Olanzapine