A randomized trial of citalopram versus placebo in outpatients with asthma and major depressive disorder: A proof of concept study

Background: The prevalence of asthma has increased in recent years and depression is common in this population. Minimal data are available on the treatment of depressed asthma patients. Methods: Ninety adults with asthma and current major depressive disorder were randomized to recieve citalopram or placebo for 12 weeks. At each visit, the Hamilton Randing Scale for Depression (HSRD), Inventory of Depressive Symptomatology - Self-Report, Asthma Control Quesionnaire, and Asthma Quality of Life Questionnaire were administered, and oral corticosteroid use assessed. Results: In the evaluable sample (n = 82), the primary outcome, a random regression analysis of HSRD scores, revealed no significant between-group differneces. Bonferroni corrected secondary outcomes revealed HRSD scores decreased significantly in both groups with a significantly greater decrease in the citalopram group at week 6. Changes in asthma symptoms were similar between groups. The groups had similar rates of oral corticosteroid use at baseline, but the citalopram group had less cortcosteroid use during the study. Changes in asthma symptom severity correlated with changes in depressive symptoms was associated. Conclusion: A reduction in depressive symptoms was associated with improvements in asthma. Corticosteroid use, an important measure of severe asthma exacerbations, was lower in the citalopram. Larger clinical trials in this population are warranted.