Responses of Myocardial Ischemia to Escitalopram Treatment
Condition: Myocardial Ischemia
MeSH terms: Myocardial Ischemia; Coronary Artery Disease; Ischemia
Intervention: Escitalopram; Placebo
Intervention description: Dosage will range from 5 mg to 20 mg once a day for the duration of the study (6 weeks). Tablets are in 5 mg or 10 mg form, depending upon the dosage the patient is prescribed.; Placebo dosage will range from 5 mg to 20 mg once a day for the duration of the study (6 weeks). Tablets are in 5 mg or 10 mg form, depending upon the dosage the patient is prescribed.
Intervention MeSH terms: Escitalopram
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Enrollment: 127.0
Sex: All
Minimum age: 21 Years
Maximum age: 90 Years
Healthy volunteers: No
Keywords: ischemic heart disease; mental stress-induced myocardial ischemia; escitalopram

Summary:

      Depression is commonly seen in patients with cardiovascular disorders. In recent studies it
      has been shown that mild to moderate depression symptoms were associated with increased
      likelihood of mental stress-induced myocardial ischemia (MSIMI), which is a risk factor of
      poor cardiac outcome. In this project, the investigators aim to assess the treatment of
      mental stress-induced myocardial ischemia in ischemic heart disease patients with mild to
      moderate depressive symptoms. This study is a six-week double-blind placebo controlled study
      to examine the effects of escitalopram on mental stress-induced myocardial ischemia. This
      study will look to show that patients with ischemic heart disease who are treated with
      escitalopram will exhibit a significant improvement of MSIMI at the end of week 6 compared to
      patients receiving placebo.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Age 21 or greater, less than 90

          -  Stable ischemic heart disease

        Exclusion Criteria:

          -  Recent myocardial infarction, coronary artery bypass graft surgery, or other
             revascularization procedures (less than 3 months ago)

          -  Left ventricular ejection fraction(LVEF) < 15% measured by echocardiography,
             radionuclide ventriculography (RNV), or cardiac catheterization

          -  Life threatening arrhythmia or arrhythmia interrupting the interpretation of ischemia

          -  Unable to withdraw from anti-anginal medications during ischemic assessment phase

          -  Unable to perform exercise testing

          -  Pregnancy

          -  Current or previous history of bipolar disorder, cyclothymia, schizophrenia,
             schizoaffective or schizophreniform disorder, or other psychotic disorders

          -  Active suicidal ideation

          -  Current substance abuse or history of substance abuse in the previous 6 months

          -  Significant cardiac, pulmonary, metabolic, renal, hepatic disease, or malignancy,
             interfering with patient's participation in this study

          -  Seizure (history and/or present) with/without treatment

          -  Currently taking antidepressants that cannot be discontinued