RESUMO
Ischemic heart disease patients (20 men, 20 women, age 36-72 years) with class II-III effort angina and depression (Beck Depression Inventory -- BDI -- score > or = 19) were randomized to standard therapy were treatment of stable ischemic heart disease (control group) or standard therapy plus tianeptine 37.5 mg/day. After 6 weeks 52% decrease of BDI score occurred in tianeptine treated patients (from 24.9+/-1.2 to 11.9+/-1.5, p<0.001). This was associated with decrease of number and severity of cardialgias, better blood pressure control in patients with hypertension, lengthening of exercise time during exercise test (by 3.3+/-0.9 min, p<0.05), and increase of overall index of quality of life (by 2.6+/-0.9 points, p<0.01). No dynamics of these parameters occurred in control group.
Assuntos
Antidepressivos Tricíclicos/uso terapêutico , Depressão/complicações , Depressão/tratamento farmacológico , Isquemia Miocárdica/complicações , Isquemia Miocárdica/tratamento farmacológico , Tiazepinas/uso terapêutico , Adulto , Idoso , Antidepressivos Tricíclicos/administração & dosagem , Fármacos Cardiovasculares/administração & dosagem , Fármacos Cardiovasculares/uso terapêutico , Depressão/diagnóstico , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/fisiopatologia , Qualidade de Vida , Fatores de Risco , Tiazepinas/administração & dosagem , Fatores de Tempo , Resultado do TratamentoRESUMO
Patients (n=28) with mild to moderate hypertension and depression were given enalapril (20 mg/day). If target blood pressure was not achieved in 10 days hydrochlorothiazide (12.5 mg/day) was added. These patients were randomized into 2 groups in one of which antihypertensive therapy was supplemented with citalopram (20 mg/day) for 6 weeks. Psychological status was assessed by Beck Depression Inventory (BDI) and Spielberger State-Trait Anxiety Inventory (STAI). Total BDI score in citalopram group decreased 51% (-12.2+/-1.5; p<0.001). Complete reduction of symptoms of depression (BDI score <19) occurred in 86% of patients. There was no significant lowering of BDI score in control group. STAI score among citalopram treated patients with concomitant anxiety (STAI score >50) decreased from initial 62.9+/-2.1 to 46.3+/-3.1 by week 6 (p<0.001). Only minor changes of STAI score took place in control group. According to data of 24-hour monitoring lowering of systolic blood pressure time indexes was somewhat more pronounced in citalopram group than in control group (24 hour -49.8 and -34.4%, diurnal -56.6 and -42%, nocturnal -37.9 and -23%, respectively).
