DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20160650

Escitalopram reduces severity of depression and improves quality of life in patients with chronic obstructive pulmonary disease in an open label parallel group study

Lakshmi Rajesh Channareddy, Eshwar Reddy Ravula, Vignan Kumar G. P.

Abstract


Background: Chronic obstructive pulmonary disease (COPD) is characterised by progressive and persistent airflow limitation with frequent exacerbations and hospitalizations contributing to overall morbidity and mortality. We evaluated the efficacy of antidepressant escitalopram therapy in depressed individuals suffering from chronic obstructive pulmonary disease.

Methods: The sample comprised of sixty patients. Thirty patients received antidepressant escitalopram, while the remaining half served as controls. Hamilton depression rating and WHO–BREF questionnaire were the tools to assess severity of depression and quality of life. The severity of COPD was recorded using spirometry (FEV1%). Clinical assessments were at baseline and at week-2 and week-8 of follow up in both intervention and control groups.

Results: It was found that both the groups were similar on the severity of the illness (COPD) at entry. FEV 1% of both the groups showed similar improvement after 8 weeks. Treatment with escitalopram showed a significant decrease in the severity of depression score and improvement on all the domains of quality of life when compared with the baseline. After the intervention, it was found that the HAM-D scores in the experimental group decreased from 24.44 to 17.50 while in the control group, it was from 20.11 to 19.67.  The magnitude of improvement was significantly higher with intervention compared to controls.

Conclusions: Escitalopram reduces severity of depression and improves quality of life which was independent of improvement in FEV1. It could be asserted that this antidepressant improved the patient’s mood, fatigue and helplessness, which could have improved the quality of life of these patients.


Keywords


Chronic obstructive pulmonary disease, Depression, Quality of life, Hamilton depression rating scale, FEV1

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References


Fabbri L, Hurd S. Global strategy for the diagnosis, management and prevention of COPD: 2003 update. European Respir J. 2003;22(1):1-2.

Xu W, Collet J-P, Shapiro S, Lin Y, Yang T, Platt RW et al. Independent effect of depression and anxiety on chronic obstructive pulmonary disease exacerbations and hospitalizations. American J Respir Crit Care Med. 2008;178(9):913-20.

Jain A, Lolak S. Psychiatric aspects of chronic lung disease. Curr Psych Reports. 2009;11(3):219-25.

Janssen DJ, Spruit MA, Leue C, Gijsen C, Hameleers H, Schols JM et al. Symptoms of anxiety and depression in COPD patients entering pulmonary rehabilitation. Chronic Respir Dis. 2010;7(3):147-57.

Jennings JH, DiGiovine B, Obeid D, Frank C. The association between depressive symptoms and acute exacerbations of COPD. Lung. 2009;187(2):128-35.

Regvat J, Žmitek A, Vegnuti M, Košnik M, Šuškovič S. Anxiety and depression during hospital treatment of exacerbation of chronic obstructive pulmonary disease. J Intern Med Res. 2011;39(3):1028-38.

Cully JA, Graham DP, Stanley MA, Ferguson CJ, Sharafkhaneh A, Souchek J et al. Quality of life in patients with chronic obstructive pulmonary disease and comorbid anxiety or depression. Psychosomatics. 2006;47(4):312-9.

Lacasse Y, Beaudoin L, Rousseau L, Maltais F. Randomized trial of paroxetine in end-stage COPD. Monaldi archives for chest disease= Archivio Monaldi per le malattie del torace/Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Universita di Napoli, Secondo ateneo. 2003;61(3):140-7.

Borson S, McDonald GJ, Gayle T, Deffebach M, Lakshminarayan S, VanTuinen C. Improvement in mood, physical symptoms, and function with nortriptyline for depression in patients with chronic obstructive pulmonary disease. Psychosomatics. 1992;33(2):190-201.

Fritzsche A, Clamor A, von Leupoldt A. Effects of medical and psychological treatment of depression in patients with COPD- a review. Respir Med. 2011;105(10):1422-33.