Citalopram or escitalopram may reduce depression and corticosteroids need in patients with asthma and depression

Major depressive disorder (MDD) is common in people with asthma. Yet, few studies have examined depression treatment in those with asthma.

A study was done to explore the relationship between antidepressant use, depressive symptoms, and asthma control, pooled data from three randomized trials of either citalopram or escitalopram were assessed.

Linear fixed effects and binary logistic regression analyses were conducted with between-subject covariates including treatment group, (original) study, and demographics. The within-subject effect of visit, as well as a treatment group × visit (between-within) interaction effect, were also evaluated. Analyses were repeated in a high asthma exacerbation subgroup having ≥ 3 oral corticosteroid bursts in the prior 12 months. Outcomes included the Hamilton Rating Scale for Depression (HAM-D17), the 7-item Asthma Control Questionnaire (ACQ), and oral corticosteroid use (yes/no).

Results:

In the pooled sample (n = 255), the antidepressant treatment group demonstrated lower HAM-D17 scores overall (p ≤ .001) and a lower likelihood for oral corticosteroid use (p ≤ .001) relative to the placebo group. In the high exacerbation subgroup (n = 96), treatment group participants had lower overall ACQ (p = .004) and HAM-D17 scores (p ≤ .001), and a lower likelihood of oral corticosteroid use (p = .003), relative to placebo participants. All treatment group interaction effects were non-significant.

Citalopram or escitalopram demonstrated efficacy in reducing depressive symptoms and the need for rescue oral corticosteroids in patients with asthma and MDD. Future work should determine whether SSRIs are effective at improving asthma outcomes in those with asthma who are not depressed.

Reference:

Catherine D. Agarwal, Jayme M. Palka, Alexander J. Gajewski, David A. Khan, E. Sherwood Brown. The Efficacy of Citalopram or Escitalopram in Patients with Asthma and Major Depressive Disorder, Annals of Allergy, Asthma & Immunology, 2023, ISSN 1081-1206,

https://doi.org/10.1016/j.anai.2023.11.004.

(https://www.sciencedirect.com/science/article/pii/S1081120623014011)

Keywords:

Citalopram, escitalopram, reduce, depressive, symptoms, corticosteroids, need, patients, asthma, depression, Annals of Allergy, Asthma & Immunology, Catherine D. Agarwal, Jayme M. Palka, Alexander J. Gajewski, David A. Khan, E. Sherwood Brow