Effects of escitalopram in prevention of depression in patients with acute coronary syndrome (DECARD).
OBJECTIVE
Depression is a major problem in patients after acute coronary syndrome (ACS) with negative impact on survival and quality of life. No studies have examined prevention of post-ACS depression. We examined whether treatment with escitalopram can prevent post-ACS depression.


METHODS
We have conducted a randomised controlled trial. Between November 2004 and December 2007, 240 patients in 2 university hospitals in Copenhagen, Denmark, with ACS were randomised. Patients were randomised to a double-blind treatment with escitalopram or matching placebo for 1 year. Main outcome measure was the incidence of ICD-10 depressive episode.


RESULTS
Of 120 patients treated with escitalopram 2 developed depression versus 10 in placebo treated group (log rank, p=0.022). In multivariate analysis treatment with placebo and high Hamilton Depression Scale score at baseline were associated with development of depression. Patients were well matched at baseline.


CONCLUSIONS
Twelve months treatment with escitalopram prevented depression in post-ACS patients.
Liaison Psychiatry Unit, Mental Health Centre Copenhagen, Bispebjerg University Hospital, Copenhagen, Denmark. baiba.hansen@gmail.com
Baiba Hedegaard
BH
Hansen
Jamal Abed
JA
Hanash
Alice
A
Rasmussen
Jørgen Fischer
JF
Hansen
Nadia Lyhne Trærup
NL
Andersen
Olav Wendelboe
OW
Nielsen
Morten
M
Birket-Smith
D054058:Acute Coronary Syndrome / Q000150:complications*; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015283:Citalopram / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome
D000928:Antidepressive Agents; D015283:Citalopram