A Randomized, Double-Blind, Placebo-Controlled Trial of Escitalopram in Patients with Asthma and Major Depressive Disorder

E. Sherwood Brown, Nasreen Sayed, Erin Van Enkevort, Alexandra Kulikova, Alyson Nakamura, David A. Khan, Elena I. Ivleva, Prabha Sunderajan, Bruce G. Bender, Traci Holmes

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Background: Depression is common in asthma and is associated with poor outcomes. However, antidepressant therapy in depressed patients with asthma has been the topic of little research. Objective: This study examined the impact of antidepressant treatment with escitalopram versus placebo on the Hamilton Rating Scale for Depression (HRSD), Inventory of Depressive Symptomatology-Self Report (IDS-SR), Asthma Control Questionnaire (ACQ), and oral corticosteroid use in patients with asthma and major depressive disorder (MDD). Methods: Single-site 12-week, randomized, double-blind, placebo-controlled, parallel-group trial of escitalopram (10 mg/d) was conducted in 139 outpatients with asthma and MDD. Randomization was stratified by oral corticosteroid use (≥3 bursts in past 12 months, yes or no) and baseline depressive symptom severity (HRSD score ≥ 20) (higher severity, n = 42) versus less than 3 bursts, HRSD score less than 20, or both (lower severity, n = 97). The primary data analysis was conducted using hierarchical linear modeling Version 7.01 on the higher and lower severity samples and post hoc was conducted on the combined sample. Results: Among the higher severity completers (n = 21), a significant reduction in the ACQ score (P =.04) and oral corticosteroid use (P =.04) was observed with escitalopram. In the combined sample, no significant differences were observed, but a trend toward greater reduction in the IDS-SR score was observed with escitalopram (P =.07). Side effects were comparable across groups. Conclusions: The findings suggest that patients with more severe asthma and depression symptomatology may have a positive response, in terms of both asthma and depressive symptom reduction, to antidepressant treatment.

Original languageEnglish (US)
Pages (from-to)1604-1612
Number of pages9
JournalJournal of Allergy and Clinical Immunology: In Practice
Issue number5
StatePublished - Sep 1 2018


  • Asthma
  • Escitalopram
  • Major depressive disorder
  • Selective serotonin reuptake inhibitor

ASJC Scopus subject areas

  • Immunology and Allergy


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