Research

Antidepressant Treatment for Asthma Outpatients

Purpose

A 12-week study to determine if antidepresssant treatment, escitalopram (Lexapro®), is associated with greater improvement in asthma and depression symptoms. We will be examining the impact of antidepressant therapy on the use of oral corticosteroids (Prednisone), unscheduled asthma-related clinic visits, ER visits, hospital admissions, and breathing performance to determine if improvement in depressive symptom severity is associated with improvement in asthma symptom severity.

Eligibility

  • Physician diagnosis of asthma
  • Currently receiving asthma treatment.
  • Age 18-70 years
  • Men and women
  • English- or Spanish-speaking.
  • No changes in asthma medications, oral corticosteroid (Prednisone) use, or respiratory infection treatment in the past 2 weeks (can schedule for 2 weeks after stabilization).

Background

Depressive symptoms and Major Depressive Disorder (MDD) are common in asthma patients. When present, depression is associated with reduced pulmonary functioning, decreased physical functioning, and increased asthma-related service utilization. Asthma also appears to be associated with an increased suicide risk. However, minimal data are available on the treatment of depressed asthma patients.

Our pilot data suggests that citalopram therapy is associated with less oral corticosteroid use, greater likelihood of sustained remission from depression, and trends toward greater improvement in quality of life than placebo. Improvement in depression is associated with improvement in asthma.

A subset of patients with more severe asthma and depression showed greater improvement in the Asthma Control Questionnaire (ACQ) with citalopram than placebo. Opolski and Wilson point out in a review on the relationship between asthma and depression that the “overdue next step” is “to design integrated treatment approaches, and carry out large-scale prospective studies to determine the impact of using such approaches to treat individuals with depression and asthma.” We propose a randomized controlled trial examining the impact of SSRI treatment on depression and asthma in patients with severe asthma and depression.

Frequently Asked Questions

Q: What medication will I be given?

A: The study medication is an SSRI antidepressant called escitalopram (Lexapro). We do not provide any asthma medications as a part of this study.

Q: How long is this study?

A: The study is 12 weeks long, with a visit every other week. It is also possible that a patient may continue into another phase with one visit each month for four months.

Q: Will I be paid if I take part in this study?

A: Yes, you will be paid for each assessment and DART bus passes will also be provided as needed.