Meta-Analysis of Antidepressant Pharmacotherapy in Patients Eligible for Cardiac Rehabilitation: ANTIDEPRESSANT AMBIVALENCE

Purpose: Many patients exhibit clinically significant depression upon enrollment in cardiac rehabilitation (CR). Antidepressants are a first-line treatment option for depression, but the effectiveness of antidepressants in patients with heart disease is mixed. The purpose of this meta-analysis was to evaluate the efficacy of antidepressants for depression in patients eligible for CR. Methods: A meta-analysis was conducted including randomized controlled trials of antidepressants from January 1990 to September 2021 that compared antidepressants with placebo. Random-effects models were used between group effect sizes (Hedges' g). Results: A total of 13 trials with predominately White (68% ± 12; n =7) male (70% ± 11) samples averaging 61 ± 5 yr compared antidepressants (1128 participants) with placebo (1079 participants). Antidepressants reduced depressive symptoms (g = 0.17: 95% CI, 0.08-0.27), but the effect was small. Heterogeneity among study effects was low (I2 = 6.42) and nonsignificant (Q = 10.75, P = .46), although patients with heart failure (gHF = 0.05: 95% CI, −0.09 to 0.18) demonstrated smaller effects compared with patients with other cardiovascular disease conditions (gnon-HF = 0.22: 95% CI, 0.11-0.32) (QB [1] = 3.97; P
Source: Journal of Cardiopulmonary Rehabilitation - Category: Rehabilitation Tags: Scientific Reviews Source Type: research