Antidepressant Ineffective in Heart Failure Patients

Escitalopram does not benefit patients with chronic heart failure and depression, according to the results of a recent study.

While depression is common in patients with heart failure and is associated with adverse outcomes, data on the safety and efficacy of selective serotonin reuptake inhibitors in this population is lacking.
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In order to examine the effect of treatment with escitalopram on mortality, morbidity, and mood in patients with chronic systolic heart failure and depression, researchers conducted a double-blind, placebo-controlled, randomized clinical trial of 372 participants, randomly assigned to receive either escitalopram (10-20 mg) or placebo, in addition to their heart failure therapy.

The trial, set to run 24 months, was stopped early due to a recommendation from the safety monitoring committee. After a median follow-up for 18.4 months for the escitalopram group and 18.7 months for the placebo group, the primary outcome of death or hospitalization occurred in 116 patients and 119 patients, respectively.

The mean Montgomery- Åsberg Depression Rating Scale sum score changed from 20.2 at baseline to 11.2 at 12 weeks in the escitalopram group and from 21.4 to 12.5 in the placebo group.

“In patients with chronic heart failure with reduced ejection fraction and depression, 18 months of treatment with escitalopram compared with placebo did not significantly reduce all-cause mortality or hospitalization, and there was no significant improvement in depression. These findings do not support the use of escitalopram in patients with chronic systolic heart failure and depression,” the researchers concluded.

—Michael Potts

Reference:

Angermann CE, Gelbrich G, Störk S, et al; MOOD-HF Study Investigators and Committee Members. Effect of escitalopram on all-cause mortality and hospitalization in patients with heart failure and depression: the MOOD-HF Randomized Clinical Trial. JAMA. 2016;315(24):2683-2693.