Antidepressant (AD) treatment in coronary artery disease (CAD) patients suffering from depression results in significant therapeutic effects without substantially increased rates of discontinuation, a new study has concluded.

According to the Canadian researchers, depression can occur in up to 45 per cent of patients with CAD, where it is associated with an increased risk of acute coronary events and mortality.

The team from Toronto performed a meta-analysis of randomised, placebo-controlled, double-blind trials with a database search of the English literature (to March 2008) and manual search of references.

Four clinical trials with ADs (mirtazapine, citalopram, fluoxetine and sertraline) of a nine- to 24-week duration involving some 798 subjects (402 ADs, 396 placebo) with documented CAD and meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for depression were included.

ADs were superior to placebo for decreasing Hamilton Depression Rating Scale (HDRS) scores (402 ADs, 396 placebo; weighted mean difference 1.41, 95 per cent CI 0.53 to 2.29, P = 0.002) and Beck Depression Inventory (BDI) scores (373 ADs, 369 placebo; weighted mean difference 2.27, 95 per cent CI 0.60 to 3.94, P = 0.008).

The proportion of patients (216 ADs, 213 placebo) who responded (a 50 per cent or more reduction in HDRS scores, OR 1.72, 95 per cent CI 1.17 to 2.54) and remitted (HDRS of 8 or less at final assessment, OR 1.80, 95 per cent CI 1.18 to 2.74), were also significantly higher with AD, compared with placebo, with no significant differences between the two groups for overall dropouts (OR 0.84, 95 per cent CI 0.42 to 1.68) or dropout owing to adverse events (OR 1.30, 95 per cent CI 0.75 to 2.25).

Cheap antidepressants in the best online drugstore.