Antidepressant Helps Heart Patients More Than Psychotherapy

In a study published in the January 24 issue of The Journal of the American Medical Association, the antidepressant citalopram (Celexa) was found to help heart disease patients more than short-term interpersonal psychotherapy (IPT).

The Canadian study included 284 patients with coronary artery disease (CAD) and major depression who were divided into two groups, half receiving either citalopram or placebo and half receiving IPT. Both groups were treated for a period of 12 weeks.

IPT was selected by the study authors because it is the only other short-term, semistructured psychotherapy aside from cognitive behavioral therapy (CBT) that is recommended in depression treatment guidelines. IPT deals with problems common in patients with CAD, including interpersonal conflicts, life transitions, grief, and loss. It also addresses social isolation, a factor that has been linked to increased mortality and morbidity in some studies of patients with CAD.

The study found that citalopram was superior to placebo, while psychotherapy did not show any benefit over drug treatment alone.

The authors recommend that citalopram or sertraline (Zoloft) plus clinical management should be considered for the initial acute-phase treatment for major depression in patients with CAD. Sertraline was recommended based upon a previous study called the Sertraline Antidepressant Heart Attack Trial (SADHART).