Table 3—

Antidepressant drug therapy in chronic obstructive pulmonary disease: summary of the published randomised controlled trials

First author [Ref.]Study designInterventionMeasurement instrumentsResults
Gordon 106Randomised double-blind crossover trial (n = 6)Desipramine versus placebo for 8 weeksDepression: Beck Depression Inventory; Zung Self-Rating Depression ScaleBoth treatments (desipramine and placebo) led to a significant improvement in depression scores
Light 107Randomised double-blind crossover trial (n = 9)Doxepin versus placebo for 6 weeksExercise capacity: 12MWDNo significant differences in either exercise capacity or psychological scores were observed
Depression: Beck Depression Inventory
Anxiety: Spielberger’s State–Trait Anxiety Inventory
Borson 56Randomised double-blind parallel groups trial (n = 30)Nortriptyline (n = 13) versus placebo (n = 17) for 12 weeksExercise capacity: 12MWDNortriptyline treatment was accompanied by improvements in anxiety, certain respiratory symptoms and day-to-day function; physiological measures remained unaffected. The clinical significance of these changes is unknown
Dyspnoea: Pulmonary Functional Status & Dyspnoea Questionnaire
Depression: Hamilton Depression Rating Scale
Anxiety: Patient-Rated Anxiety Scale
Ström 108Randomised double-blind parallel groups trial (n = 26)Protriptyline (n = 14) versus placebo (n = 12) for 12 weeksDyspnoea: 6-point scale developed for the purpose of the studyNo significant difference in quality-of-life questionnaire scores in either of the two treatment groups; neither proptriptyline nor placebo had any impact on the dyspnoea score
Quality of life: Sickness Impact Profile
Anxiety and depression: Mood Adjective Check List; Hospital Anxiety and Depression Scale
Lacasse 109Randomised double-blind parallel groups trial (n = 15)Paroxetine (n = 8) versus placebo (n = 7) for 12 weeksQuality of life: Chronic Respiratory Disease QuestionnaireIn the per protocol analysis, statistically and clinically significant improvement favouring the active treatment in the emotional function and mastery domains of the Chronic Respiratory Disease Questionnaire
Depression: Geriatric Depression ScaleNo significant difference in depression scores
Eiser 110Randomised double-blind parallel groups trial (n = 23)Paroxetine (n = 11) versus placebo (n = 12) for 6 weeksQuality of life: St George’s Respiratory QuestionnaireNo significant difference in either exercise capacity or psychological scores was observed
Exercise tolerance: 6MWD
Depression: Hospital Anxiety and Depression Scale; Beck Depression Inventory; Montgomery–Asberg Depression Scale
  • Numbers of patients shown are those completing the trial. 12MWD: 12-min walking distance; 6MWD: 6-min walking distance.