The use of statins for the treatment of depression in patients with acute coronary syndrome.
This study aimed to investigate the effect of statins for the treatment of depression in individuals with acute coronary syndrome (ACS). We used 1-year follow-up data of a 24-week double-blind, placebo-controlled trial of escitalopram and a naturalistic prospective observational cohort study. Of 446 participants with comorbid depressive disorders and ACS at baseline, 300 participated in a randomised escitalopram trial and the remaining 146 participated in a naturalistic observational study. The participants in the two studies were approached for a 1-year follow-up investigation. Treatment response rates, defined as a ⩾ 50% reduction in the Hamilton Depression Rating Scale (HAM-D) and Beck Depression Inventory (BDI) scores, were used as the outcome variables. In the escitalopram trial, both HAM-D and BDI response rates were highest in patients taking escitalopram and statins together and lowest in patients receiving neither medication. Logistic regression analyses revealed that statin use was significantly associated with higher response rates on both the HAM-D and BDI at 1 year, whereas no such associations were found for escitalopram. In the naturalistic observational study, the response rates at 1 year did not differ significantly by statin use. Instead, the HAM-D response rate was significantly higher in patients taking lipophilic statins than in those who did not. In conclusion, statins may be effective for the treatment of depression independent of medical status and escitalopram use, and they may potentiate the antidepressant action of serotonergic antidepressants in patients with ACS.
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
S W
SW
Kim
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
K Y
KY
Bae
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
J M
JM
Kim
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
I S
IS
Shin
Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea.
Y J
YJ
Hong
Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea.
Y
Y
Ahn
Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea.
M H
MH
Jeong
1] IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia [2] Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia.
M
M
Berk
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
J S
JS
Yoon
D054058:Acute Coronary Syndrome / Q000150:complications* / Q000188:drug therapy*; D015283:Citalopram / Q000627:therapeutic use*; D015331:Cohort Studies; D003866:Depressive Disorder / Q000150:complications* / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
D015283:Citalopram; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors