Statins Have No Additional Antidepressive Effects as Add-On Treatment
Investigators found that simvastatin added to escitalopram for patients with obesity and major depressive disorder did not have increased antidepressive effects.
Simvastatin did not show additional antidepressive effects when added to escitalopram for patients who have obesity and major depressive disorder, according to results of a study published in JAMA Psychiatry. Satin medications are known to reduce the risk of atherosclerosis, heart attack, and stroke, and small studies suggested the class of medication might have antidepressive effects.1,2
Investigators found that simvastatin added to escitalopram for patients with obesity and major depressive disorder did not have increased antidepressive effects. | Image Credit: Rob hyrons - stock.adobe.com
“If statins really did have this antidepressive effect, we could kill 2 birds with 1 stone,” Christian Otte, MD, director of the department of psychiatry and neurosciences on the Charité Campus Benjamin Franklin, said in a news release.2 “Depression and adiposity, or obesity, are among the most common medical conditions globally, and they actually often appear together: Those who are obese are at a higher risk of depression. In turn, those with depression are at a higher risk of obesity.”
Statins are recommended as the primary prevention of cardiovascular disease, and a pilot randomized controlled trial did find statins, when used as an adjunct to antidepressants, had some antidepressive effects. However, this was never confirmed by another study. Therefore, investigators of the current study added simvastatin to treatment with escitalopram to see if it could improve depression for patients who have obesity and major depressive disorder. They included 106 patients who received randomized treatment of either simvastatin or the placebo in addition to escitalopram for 12 weeks.3
The primary outcome included the change score in the Montgomery-Asberg Depression Rating Scale (MADRS) at 12 weeks. Secondary outcomes included MADRS-response, -remission, and -minimal clinically important difference (MCID); change score in Beck Depression-Inventory II, and -MCID; change in Patients’ Global Impression Change Scale, Clinicians’ Global Impression of Severity of Illness, Clinicians’ Global Impression of Improvement, EuroQol-5 Dimensions-3 Levels Questionnaire, and Social and Occupational Functioning Assessment Scale.3
Investigators assigned treatment with simvastatin to 81 patients and 79 with the placebo. They had a mean age of 39 years, and 79% were female. Approximately 95.6% completed the study, with only 3 patients in the simvastatin group and 4 in the placebo group discontinuing treatment. Although MADRS scores decreased from baseline to week 12 (–13.97 points for simvastatin and –12.06 for the placebo), there were no significant treatment effects for the add on of simvastatin compared with the placebo in MADRS scores. As for the secondary outcomes, both groups showed decreases in depressive symptoms, but there were no significant differences.1
Although there were no differences in mental health improvements, simvastatin did significantly affect metabolic health by reducing low-density lipoprotein, total cholesterol, and C-reactive protein, according to the study authors. There were 4 total serious adverse events in 2 patients, and no significant difference between the groups. A total of 123 individuals did report adverse events during the trial, with the most common being headache and nausea, and there were no significant differences between the groups. No patients experienced high levels of suicidality at any time point.1
“So, unfortunately, this does not point to an additional antidepressive effect,” Otte said in the news release.2 “When it comes to treating depression, statins therefore have no additional benefit. To our present knowledge, traditional antidepressants remain the gold standard.”
READ MORE: Mental and Behavioral Health Resource Center
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