Improvement in Mood, Physical Symptoms, and Function With Nortriptyline for Depression in Patients With Chronic Obstructive Pulmonary Disease

Borson, Soo; McDonald, Gwendolyn J.; Gayle, Terence C.; Deffebach, Mark; Lakshminarayan, S.; VanTuinen, Craig

doi:10.1016/s0033-3182(92)71995-1

Cited by 266 publications

(144 citation statements)

References 31 publications

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“…Only three double-blind clinical trials were found involving the tricyclic antidepressants (TCAs) doxepin, imipramine (combined with diazepam) and nortriptyline (table 3) [52][53][54].…”

Section: Effects Of Antidepressants Effects Of Tricyclic Antidepressantsmentioning

confidence: 99%

“…One study [54] reported a large effect size for nortriptyline (Cohen's d -1.07) compared with placebo [10]; however, as only 30 patients completed the study it was strongly underpowered. Due to even more serious methodological limitations of the remaining studies no firm conclusions can be drawn concerning TCAs in patients with comorbid depression and COPD.…”

Section: Effects Of Antidepressants Effects Of Tricyclic Antidepressantsmentioning

confidence: 99%

“…Regarding effects of TCAs on lung function in patients with COPD, neither effects on spirometry [52][53][54] or on peak expiratory flow rates [53] and respiratory function measured by arterial blood gases [54] have been found.…”

Section: Effects Of Antidepressants Effects Of Tricyclic Antidepressantsmentioning

confidence: 99%

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Depression and suicidality in COPD: understandable reaction or independent disorders?

Hegerl

Mergl

2014

European Respiratory Journal

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Both depression and chronic obstructive pulmonary disease (COPD) are prevalent, severe and often comorbid disorders. There is a risk of undertreatment for depression in patients with COPD as depressive symptoms, including suicidal tendencies, can erroneously be conceptualised as an understandable reaction to COPD and not as signs of an independent depressive disorder. In this context, the comorbidity rates of COPD and depression, the risk of suicidal behaviour in patients with COPD, and the evidence base for pharmaco-and psychotherapy in these patients are reviewed.Because symptoms of depression and COPD overlap it remains unclear how far the prevalence of major depression in COPD exceeds that in the general population. The suicide risk appears to be increased in COPD. Methodological studies providing evidence for the antidepressant efficacy of antidepressants or psychotherapy in patients with COPD are lacking. Recommendations for clinicians on how to separate depression from an understandable reaction to COPD are provided.Given the profound effects of depression on quality of life, life expectancy, COPD prognosis and suicide risk it is important to carefully diagnose and treat depression in patients with COPD according to national guidelines. @ERSpublications Comorbid depression has profound effects on COPD prognosis and should not be seen as understandable reaction to COPD

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“…Only three double-blind clinical trials were found involving the tricyclic antidepressants (TCAs) doxepin, imipramine (combined with diazepam) and nortriptyline (table 3) [52][53][54].…”

Section: Effects Of Antidepressants Effects Of Tricyclic Antidepressantsmentioning

confidence: 99%

Section: Effects Of Antidepressants Effects Of Tricyclic Antidepressantsmentioning

confidence: 99%

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Depression and suicidality in COPD: understandable reaction or independent disorders?

Hegerl

Mergl

2014

European Respiratory Journal

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“…In a recent study, only a third of patients with COPD and clinically significant depression or anxiety were being treated and only half of those with severe depression or anxiety were being treated [53]. Antidepressants can significantly improve mood among patients with COPD and depression [54]. Furthermore, in patients with COPD and depression, antidepressants can also decrease ratings of dyspnoea and other physical symptoms [54].…”

Section: The Role Of Depression and Health Status In Communication Abmentioning

confidence: 99%

“…Antidepressants can significantly improve mood among patients with COPD and depression [54]. Furthermore, in patients with COPD and depression, antidepressants can also decrease ratings of dyspnoea and other physical symptoms [54].…”

Section: The Role Of Depression and Health Status In Communication Abmentioning

confidence: 99%

Palliative and end-of-life care for patients with severe COPD

Curtis

2008

European Respiratory Journal

236

239

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Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. For many patients, maximal therapy for COPD produces only modest or incomplete relief of disabling symptoms and these symptoms result in a significantly reduced quality of life.Despite the high morbidity and mortality associated with severe COPD, many patients receive inadequate palliative care. There are several reasons for this. First, patient-physician communication about palliative and end-of-life care is infrequent and often of poor quality. Secondly, the uncertainty in predicting prognosis for patients with COPD makes communication about end-oflife care more difficult. Consequently, patients and their families frequently do not understand that severe COPD is often a progressive and terminal illness.The purpose of the present review is to summarise recent research regarding palliative and end-of-life care for patients with COPD. Recent studies provide insight and guidance into ways to improve communication about end-of-life care and thereby improve the quality of palliative and end-of-life care the patients receive. Two areas that may influence the quality of care are also highlighted: 1) the role of anxiety and depression, common problems for patients with COPD; and 2) the importance of advance care planning.Improving communication represents an important opportunity for the improvement of the quality of palliative and end-of-life care received by these patients.

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