Efficacy and acceptability of antidepressants in patients with ischemic heart disease: systematic review and meta-analysis.
Int Clin Psychopharmacol
; 34(2): 65-75, 2019 03.
Article
en En
| MEDLINE
| ID: mdl-30531552
ABSTRACT
To assess the efficacy and acceptability of antidepressants in adults with ischemic heart disease (IHD). We gathered all available randomized-controlled trials comparing antidepressants versus placebo or other antidepressants in adults with IHD. The primary outcome was depressive symptoms at the study endpoint, as measured by validated rating scales. We pooled data in a meta-analysis using a random-effects model. The confidence in the estimates (or certainty of the evidence) was assessed using the GRADE approach. Antidepressants appeared to be more effective than placebo in reducing depressive symptoms (11 comparisons; 1685 participants; standardized mean difference -0.71, 95% confidence interval -1.11 to -0.30; GRADE quality moderate). This result was confirmed in the subgroup of serotonin selective reuptake inhibitors, and for the single drugs sertraline and citalopram, with a greater magnitude of effect and a higher quality of evidence for the former. No differences between antidepressants and placebo emerged in terms of acceptability and tolerability, quality of life, mortality, and cardiovascular events. Only two small head-to-head studies were identified. Sertraline is a reasonable first-line choice in patients with IHD and depression, whereas the role of citalopram as the first-line agent should be reconsidered.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_cardiovascular_diseases
/
6_ischemic_heart_disease
/
6_mental_health_behavioral_disorders
Asunto principal:
Isquemia Miocárdica
/
Depresión
/
Antidepresivos
Tipo de estudio:
Clinical_trials
/
Systematic_reviews
Aspecto:
Patient_preference
Límite:
Adult
/
Humans
Idioma:
En
Revista:
Int Clin Psychopharmacol
Asunto de la revista:
PSICOFARMACOLOGIA
Año:
2019
Tipo del documento:
Article