Using escitalopram for patients with chronic heart failure and depression for more than 18 months neither significantly reduces mortality or hospitalization, nor improves depression, a study published June 28 involving 372 patients shows.
“To our knowledge, this study was the first to investigate the composite all-cause mortality and hospitalization in a population with heart failure treated with escitalopram,” wrote Dr. Christiane E. Angermann and her associates.
They said the only other randomized trial evaluating selective serotonin reuptake inhibitors in patients with heart failure was the Sertraline Against Depression and Heart Disease in Chronic Heart Failure study, which found that sertraline did not improve depression or cardiovascular status. But the treatment duration in that study was only 12 weeks, reported Dr. Angermann of the Cardiology and Comprehensive Heart Failure Center, Würzburg, Germany.
The current study, called the Effects of Selective Serotonin Re-Uptake Inhibition on Morbidity, Mortality, and Mood in Depressed Heart Failure Patients, was a double-blind, placebo-controlled randomized trial conducted at 16 tertiary medical centers in Germany. Three hundred seventy-two patients (185 in the escitalopram group and 187 in the placebo group) were randomized and given at least one dose of the study medication. The study was supposed to last for 24 months, but the investigators stopped it early.
Primary outcome of death or hospitalization occurred in 116 (63%) patients and 119 (64%) patients, respectively (hazard ratio, 0.99; 95% confidence interval, 0.76-1.27; P = .92).
Read more of the study and findings on the JAMA website (doi: 10.1001/jama.2016.7635).