Key result
Treatment with statin plus SSRIs significantly decreased the Hamilton depression rating scale score (MD -2.79) compared to SSRIs alone in adult patients with major depressive disorder.
Why the study?
Small trials showed beneficial effects of statins on depressive mood in major depressive disorder, but observational studies suggested an increased risk of anxiety/depression with statin therapy.
Does statin plus SSRIs improve depressive symptoms and inflammation in adult patients with major depressive disorder?
Meta-Analysis (n=448)
Does statin plus SSRIs improve depressive symptoms and inflammation in adult patients with major depressive disorder?
Statins used as an add-on treatment to SSRIs safely and effectively improve depressive symptoms and inflammation status in patients with major depressive disorder.
Answers are grounded in this paper and cite their sources.
Adjunctive statins with SSRIs may improve MDD outcomes; extends evidence for anti-inflammatory augmentation but requires RCT confirmation.
Introduction Several small sample-sized clinical trials have demonstrated a beneficial effect of statin on depressive mood among major depressive disorder (MDD) patients. However, observational studies have showed the increased risk of anxiety/depression with statin treatment. Therefore, we aimed to evaluate the effects of statin on depressive mood and inflammation status among MDD patients. Methods We performed an updated meta-analysis RCTs identified in systematic searches of PubMed, Cochrane library, Embase, ClinicalTrials.gov , CNKI, Wan fang, VIP, and SinoMed database (up to August 2023). The primary endpoint was the Hamilton depression rating scale (HDRS). The secondary endpoints were rate of response to treatment, remission rate, levels of C-reactive protein (CRP), cognition and blood lipid. We evaluated the certainty of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results The search identified seven RCTs involving 448 patients with a median follow-up of 10.4 weeks (range, 6–12 weeks). Compared with selective serotonin reuptake inhibitors (SSRIs) alone, treatment with statin plus SSRIs was associated with a significantly decreased HDRS [mean difference (MD) = −2.79; 95% confidence interval (CI): −3.83 to −1.76] and C-reactive protein (MD = −0.42 mg/L; 95% CI: −0.53 to −0.12 mg/L), and decreased levels of lipid profiles ( P < 0.05). Moreover, statin plus SSRIs was associated with a comparable rate of treatment response [relative risk (RR) = 1.26; 95% CI: 0.98 to 1.62], remission rate (RR = 1.33; 95% CI: 0.89 to 1.99). Meta-regression indicated that the follow-up period was a source of heterogeneity regarding the HDRS ( r = 0.302, P = 0.041). The quality of evidence was rated as moderate for HDRS and response rate according to the GRADE. Conclusion Statin could safely and effectively improve the symptoms of depression and inflammation status among MDD patients. Systematic review registration https://inplasy.com/inplasy-2022-3-0016/ , identifier INPLASY2022230016.
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Xiao et al. (2023) conducted a meta-analysis in Major Depressive Disorder (MDD) (n=448). Statin plus SSRIs vs. SSRIs alone was evaluated on Hamilton depression rating scale (HDRS) score (MD -2.79, 95% CI -3.83 to -1.76, p=<0.001). Treatment with statin plus SSRIs significantly decreased the Hamilton depression rating scale score (MD -2.79) compared to SSRIs alone in adult patients with major depressive disorder.
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