A Randomized, Double-Blind, Placebo-Controlled Trial of Escitalopram in Patients with Asthma and Major Depressive Disorder

Abstract

<div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d4582120e203">Background</h5> <p id="P2">Depression is common in asthma and is associated with poor outcomes. However, antidepressant therapy in depressed asthma patients has been the topic of little research. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d4582120e208">Objective</h5> <p id="P3">This study examined the impact of antidepressant treatment with escitalopram vs. placebo on the Hamilton Rating Scale for Depression (HRSD), Inventory of Depressive Symptomatology-Self Report (IDS-SR), Asthma Control Questionnaire (ACQ), and oral corticosteroid use in asthma patients with major depressive disorder (MDD). </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d4582120e213">Methods</h5> <p id="P4">Single site 12-week, randomized, double-blind, placebo-controlled, parallel-group trial of escitalopram (10 mg/d) was conducted in 139 outpatients with asthma and MDD. Randomization was stratified by oral corticosteroid use (≥ 3 bursts in past 12 months, yes or no) and baseline depressive symptom severity (HRSD ≥ 20) (higher severity, n=42) vs. &lt; 3 bursts, HRSD &lt; 20 or both (lower severity, n=97). The primary data analysis was conducted using HLM Version 7.01 on the higher and lower severity samples and <i>post hoc</i> was conducted on the combined sample. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d4582120e221">Results</h5> <p id="P5">Among the higher severity completers (n=21), a significant reduction in the ACQ (p=0.04) and oral corticosteroid use (p=0.04) was observed with escitalopram. In the combined sample, no significant differences were observed, but a trend toward greater reduction in the IDS-SR was observed with escitalopram (p=0.07). Side effects were comparable across groups. </p> </div><div class="section"> <a class="named-anchor" id="S5"> <!-- named anchor --> </a> <h5 class="section-title" id="d4582120e226">Conclusion</h5> <p id="P6">The findings suggest that patients with more severe asthma and depression symptomatology may have a positive response, in terms of both asthma and depressive symptom reduction, to antidepressant treatment. </p> </div>