Seyed Hesameddin Abbasi1, Payam Mohammadinejad2, Nazila Shahmansouri3, Abbas Salehiomran3, Akram Arjmandi Beglar3, Atefeh Zeinoddini2, Saeedeh Forghani4, Shahin Akhondzadeh5. 1. Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran; Family Health Research Center, Iranian Petroleum Industry Health Research Institute, Tehran, Iran. 2. Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran. 3. Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 4. Razi Vaccine and Serum Research Institute, Karaj, Iran. 5. Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: s.akhond@neda.net.
Abstract
BACKGROUND: A decreased risk of developing depression has been reported among statin users. Aside from their lipid-lowering effects, statins are considered immunomodulatory agents and have protective effects against oxidative stress and inflammation which are well known for their association with depression. The aim of the present study was to compare the probable antidepressant effects of simvastatin and atorvastatin among post-coronary artery bypass graft (CABG) surgery patients with high and low potentials for blood-brain-barrier penetration, respectively. METHOD: Forty-six outpatients who had undergone CABG in the last 6 months and suffered from mild to moderate depression participated in a parallel, double-blind, placebo-controlled trial, and were randomized to undergo 6 weeks of treatment with either simvastatin (20mg/day) or atorvastatin (20mg/day). Participants were evaluated using Hamilton depression rating scale (HDRS) at baseline and weeks 3 and 6. The primary outcome was to evaluate the efficacy of simvastatin in improving the depressive symptoms. RESULT: General linear model repeated measures demonstrated significant effect for time×treatment interaction on the HDRS scores [F (1.62, 71.06)=3.41, P=0.048]. There was no significant difference between the treatment groups regarding the adverse events. No one experienced serious adverse event. LIMITATION: The limitations of the present study were its small sample size and the short-term follow-up period. CONCLUSION: Treatment with simvastatin seems to be well tolerated with superior antidepressant effects compared to atorvastatin in post-CABG patients. Long-term outcomes of this practice and its probable influence on other psychological aspects are yet to be investigated in future studies. TRIAL REGISTRATION: Iranian registry of clinical trials (http://www.irct.ir): IRCT201410271556N68.
RCT Entities:
BACKGROUND: A decreased risk of developing depression has been reported among statin users. Aside from their lipid-lowering effects, statins are considered immunomodulatory agents and have protective effects against oxidative stress and inflammation which are well known for their association with depression. The aim of the present study was to compare the probable antidepressant effects of simvastatin and atorvastatin among post-coronary artery bypass graft (CABG) surgery patients with high and low potentials for blood-brain-barrier penetration, respectively. METHOD: Forty-six outpatients who had undergone CABG in the last 6 months and suffered from mild to moderate depression participated in a parallel, double-blind, placebo-controlled trial, and were randomized to undergo 6 weeks of treatment with either simvastatin (20mg/day) or atorvastatin (20mg/day). Participants were evaluated using Hamilton depression rating scale (HDRS) at baseline and weeks 3 and 6. The primary outcome was to evaluate the efficacy of simvastatin in improving the depressive symptoms. RESULT: General linear model repeated measures demonstrated significant effect for time×treatment interaction on the HDRS scores [F (1.62, 71.06)=3.41, P=0.048]. There was no significant difference between the treatment groups regarding the adverse events. No one experienced serious adverse event. LIMITATION: The limitations of the present study were its small sample size and the short-term follow-up period. CONCLUSION: Treatment with simvastatin seems to be well tolerated with superior antidepressant effects compared to atorvastatin in post-CABG patients. Long-term outcomes of this practice and its probable influence on other psychological aspects are yet to be investigated in future studies. TRIAL REGISTRATION: Iranian registry of clinical trials (http://www.irct.ir): IRCT201410271556N68.
Authors: Christian Otte; Woo Ri Chae; Jan Nowacki; Michael Kaczmarczyk; Dominique Piber; Stefan Roepke; Stefanie Märschenz; Sandra Lischewski; Sein Schmidt; Barbara Ettrich; Hans Joergen Grabe; Ulrich Hegerl; Kim Hinkelmann; Tobias Hofmann; Deborah Janowitz; Klaus Junghanns; Kai G Kahl; Jan Philipp Klein; Tillmann H C Krueger; Gregor Leicht; David Prvulovic; Andreas Reif; Daniel Schoettle; Maria Strauss; Anna Westermair; Tim Friede; Stefan M Gold Journal: BMJ Open Date: 2020-12-01 Impact factor: 2.692