Treating Depressed Heart Patients

Ivanhoe Newswire
Wednesday, January 24, 2007; 12:00 AM

(Ivanhoe Newswire) -- Patients with heart disease can get better relief for their depression from a common antidepressant than from short-term psychotherapy.

Previous research has suggested major depression is present in 17 percent to 27 percent of patients hospitalized with coronary artery disease (CAD). For many patients, the depression can negatively affect their heart health.

Canadian researchers looked at the short-term use of citalopram (Celexa) -- a selective serotonin reuptake inhibitor (SSRI) antidepressant -- and interpersonal psychotherapy (IPT) -- a short-term psychotherapy focusing on the social context of depression.

Study participants got 12 weekly IPT sessions plus clinical management or clinical management alone and either 12 weeks of citalopram or a placebo.

Clinical management sessions included information about depression and medication use, reassurance, and encouragement to stick to taking the drug. IPT sessions included dealing with common problems in CAD patients, such as interpersonal conflicts, life transitions, grief, and loss.

Results reveal citalopram was much better than a placebo in reducing symptoms of depression. Patients reported they could feel the benefits after taking the drug for six weeks. The study also found both IPT and clinical management helped patients get better, but there was no evidence IPT was better.

The authors conclude, "Citalopram (or sertraline, as previously shown in [a different] trial) plus clinical management should be considered for the initial acute-phase treatment for major depression in patients with CAD. It remains to be demonstrated that any form of psychotherapy is superior to clinical management in reducing depression symptoms in this group."

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SOURCE: The Journal of the American Medical Association, 2007;297:367-379